Provider Demographics
NPI:1245613306
Name:LENIHAN, MEGAN DIANE (PHARMD)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:DIANE
Last Name:LENIHAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4257 YELLOWSTONE AVE
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83202-2419
Mailing Address - Country:US
Mailing Address - Phone:208-237-3940
Mailing Address - Fax:208-237-9257
Practice Address - Street 1:4257 YELLOWSTONE AVE
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83202-2419
Practice Address - Country:US
Practice Address - Phone:208-237-3940
Practice Address - Fax:208-237-9257
Is Sole Proprietor?:No
Enumeration Date:2015-07-07
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP449637183500000X
IDP7369183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist