Provider Demographics
NPI:1598051419
Name:STERLING, DARRELL D (RPH)
Entity Type:Individual
Prefix:MR
First Name:DARRELL
Middle Name:D
Last Name:STERLING
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 1:4710 WISTERIA PL
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83713-9575
Mailing Address - Country:US
Mailing Address - Phone:208-830-6135
Mailing Address - Fax:
Practice Address - Street 1:4700 N EAGLE RD
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83713-0744
Practice Address - Country:US
Practice Address - Phone:208-939-5149
Practice Address - Fax:208-939-5282
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-20
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP4442183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist