Provider Demographics
NPI:1336685445
Name:MUNIE, RUTH TADIOS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:TADIOS
Last Name:MUNIE
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 1:414 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MOSCOW
Mailing Address - State:ID
Mailing Address - Zip Code:83843-2631
Mailing Address - Country:US
Mailing Address - Phone:208-882-6076
Mailing Address - Fax:208-882-6846
Practice Address - Street 1:414 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MOSCOW
Practice Address - State:ID
Practice Address - Zip Code:83843-2631
Practice Address - Country:US
Practice Address - Phone:208-882-6076
Practice Address - Fax:208-882-6846
Is Sole Proprietor?:No
Enumeration Date:2017-01-12
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP7691183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist