Provider Demographics
NPI:1821706144
Name:CAZEAU, ALAN REID (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:REID
Last Name:CAZEAU
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:937 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BURLEY
Mailing Address - State:ID
Mailing Address - Zip Code:83318-2035
Mailing Address - Country:US
Mailing Address - Phone:208-678-3286
Mailing Address - Fax:208-678-1679
Practice Address - Street 1:937 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BURLEY
Practice Address - State:ID
Practice Address - Zip Code:83318-2035
Practice Address - Country:US
Practice Address - Phone:208-678-6286
Practice Address - Fax:208-678-1679
Is Sole Proprietor?:No
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP10295183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist