Provider Demographics
NPI:1649980426
Name:MURRAY, CORTNEY (PHARM D)
Entity type:Individual
Prefix:DR
First Name:CORTNEY
Middle Name:
Last Name:MURRAY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4240 YELLOWSTONE AVE
Mailing Address - Street 2:
Mailing Address - City:CHUBBUCK
Mailing Address - State:ID
Mailing Address - Zip Code:83202-2420
Mailing Address - Country:US
Mailing Address - Phone:208-237-5091
Mailing Address - Fax:
Practice Address - Street 1:4240 YELLOWSTONE AVE
Practice Address - Street 2:
Practice Address - City:CHUBBUCK
Practice Address - State:ID
Practice Address - Zip Code:83202-2420
Practice Address - Country:US
Practice Address - Phone:208-237-5091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-01
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP10437183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDP10437OtherPHARMACIST LICENSE