Provider Demographics
NPI:1053749101
Name:BELL, DUNCAN (RPH)
Entity type:Individual
Prefix:
First Name:DUNCAN
Middle Name:
Last Name:BELL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15837 N WESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:RATHDRUM
Mailing Address - State:ID
Mailing Address - Zip Code:83858-6432
Mailing Address - Country:US
Mailing Address - Phone:208-687-5717
Mailing Address - Fax:
Practice Address - Street 1:15837 N WESTWOOD DR
Practice Address - Street 2:
Practice Address - City:RATHDRUM
Practice Address - State:ID
Practice Address - Zip Code:83858-6432
Practice Address - Country:US
Practice Address - Phone:208-687-5717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-29
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP4290183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDP4290OtherPHARMACY LICENSE