Provider Demographics
NPI:1003198508
Name:MURPHY, ROGER FRANKLIN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:FRANKLIN
Last Name:MURPHY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 EAST YOUNG STREET
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83201
Mailing Address - Country:US
Mailing Address - Phone:208-232-0049
Mailing Address - Fax:208-232-3963
Practice Address - Street 1:1015 E YOUNG ST
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83201-5282
Practice Address - Country:US
Practice Address - Phone:208-232-0049
Practice Address - Fax:208-232-3963
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-12
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP5029183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist