Provider Demographics
NPI:1477826253
Name:BOHNER, HERBERT (RPH)
Entity type:Individual
Prefix:MR
First Name:HERBERT
Middle Name:
Last Name:BOHNER
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 1:4440 HOLDEN LN
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ID
Mailing Address - Zip Code:83501-6256
Mailing Address - Country:US
Mailing Address - Phone:541-729-0651
Mailing Address - Fax:
Practice Address - Street 1:306 5TH ST
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:WA
Practice Address - Zip Code:99403-1860
Practice Address - Country:US
Practice Address - Phone:509-758-6660
Practice Address - Fax:509-758-9461
Is Sole Proprietor?:No
Enumeration Date:2012-02-09
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0009463-P183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDP10031OtherSTATE PHARMACIST LICENSE
WAPH61359057OtherSTATE PHARMACIST LICENSE