Provider Demographics
NPI:1508545237
Name:MPRX CALDWELL INC
Entity Type:Organization
Organization Name:MPRX CALDWELL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEVIN
Authorized Official - Middle Name:R
Authorized Official - Last Name:TRONE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:208-288-1496
Mailing Address - Street 1:2790 W CHERRY LN STE 100
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-1102
Mailing Address - Country:US
Mailing Address - Phone:208-204-5900
Mailing Address - Fax:208-204-5901
Practice Address - Street 1:4618 BEACON LN STE 100
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:ID
Practice Address - Zip Code:83605-4879
Practice Address - Country:US
Practice Address - Phone:208-204-5900
Practice Address - Fax:208-204-5901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy