IndividualActive
Kim Tillery, RPH
NPI 1508096777 · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Twin Falls, ID
Provider details
- NPI number
- 1508096777
- Entity type
- Individual
- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistPharmacy Service Providers
- Credential
- RPH
- Sex
- Male
- Sole proprietor
- Yes
- License
- P4585 (ID)
Practice location
2638 Longbow Dr
Twin Falls, ID 83301-8946
Phone: (208) 735-4076
Fax: (208) 324-4599
Mailing address
2638 Longbow Dr
Twin Falls, ID 83301-8946
Registry dates
- Enumerated
- 2009-07-21
- Last updated
- 2009-07-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.