IndividualActive
Alex Lystrup, PHARMD
NPI 1124670831 · Pharmacotherapy Pharmacist · Pocatello, ID
Provider details
- NPI number
- 1124670831
- Entity type
- Individual
- Primary specialty
- Pharmacotherapy PharmacistPharmacy Service Providers
- Credential
- PHARMD
- Sex
- Male
- Sole proprietor
- No
- License
- P8065 (ID)
Specialties & taxonomies
Pharmacy Service Providers
Practice location
465 Memorial Dr
Pocatello, ID 83201-4008
Phone: (208) 234-4700
Approximate (ZIP-level) locationGet directions
Mailing address
465 Memorial Dr
Pocatello, ID 83201-4008
Registry dates
- Enumerated
- 2019-07-12
- Last updated
- 2019-07-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.