Provider Demographics
NPI:1659652840
Name:AUNE, MERRIT (RPH)
Entity Type:Individual
Prefix:
First Name:MERRIT
Middle Name:
Last Name:AUNE
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 1:4515 OLD FREEZE OUT RD
Mailing Address - Street 2:
Mailing Address - City:EMMETT
Mailing Address - State:ID
Mailing Address - Zip Code:83617-9578
Mailing Address - Country:US
Mailing Address - Phone:208-447-6196
Mailing Address - Fax:
Practice Address - Street 1:640 HIGHWAY 16
Practice Address - Street 2:
Practice Address - City:EMMETT
Practice Address - State:ID
Practice Address - Zip Code:83617-9461
Practice Address - Country:US
Practice Address - Phone:208-365-4128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-01
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP4498183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist