Provider Demographics
NPI:1790837292
Name:LEMON, CHRISTOPHER (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:
Last Name:LEMON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:CHRIS
Other - Middle Name:C
Other - Last Name:LEMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:700 EAST ALICE
Mailing Address - Street 2:STATE HOSPITAL SOUTH
Mailing Address - City:BLACKFOOT
Mailing Address - State:ID
Mailing Address - Zip Code:83221-0400
Mailing Address - Country:US
Mailing Address - Phone:208-785-8505
Mailing Address - Fax:
Practice Address - Street 1:STATE HOSPITAL SOUTH PHARMACY
Practice Address - Street 2:700 EAST ALICE STREE
Practice Address - City:BLACKFOOT
Practice Address - State:ID
Practice Address - Zip Code:83221
Practice Address - Country:US
Practice Address - Phone:208-785-8505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP5100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist