Provider Demographics
NPI:1942624515
Name:MURRAY, MATTHEW C (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:C
Last Name:MURRAY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:149 W STATE ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:EAGLE
Mailing Address - State:ID
Mailing Address - Zip Code:83616-4901
Mailing Address - Country:US
Mailing Address - Phone:208-939-8008
Mailing Address - Fax:208-938-1067
Practice Address - Street 1:149 W STATE ST
Practice Address - Street 2:SUITE 101
Practice Address - City:EAGLE
Practice Address - State:ID
Practice Address - Zip Code:83616-4901
Practice Address - Country:US
Practice Address - Phone:208-939-8008
Practice Address - Fax:208-938-1067
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-18
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP6426183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist