IndividualActive
Mary Clark, CPHT
NPI 1639840911 · Pharmacy Technician · Orofino, ID
Provider details
- NPI number
- 1639840911
- Entity type
- Individual
- Primary specialty
- Pharmacy TechnicianPharmacy Service Providers
- Credential
- CPHT
- Sex
- Female
- Sole proprietor
- No
- License
- 30178781 (ID)
Specialties & taxonomies
Pharmacy Service Providers
Practice location
1105 Michigan Ave
Orofino, ID 83544-9005
Phone: (208) 476-3600
Approximate (ZIP-level) locationGet directions
Mailing address
89 Sunnyside Bench Rd
Lenore, ID 83541-5028
Registry dates
- Enumerated
- 2021-09-25
- Last updated
- 2021-09-25
- Certified
- 2021-09-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.