Provider Demographics
NPI:1831407949
Name:HOWARD, LORI JEAN (PHARMD)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:JEAN
Last Name:HOWARD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1319 HIGHWAY 2 STE A
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-2729
Mailing Address - Country:US
Mailing Address - Phone:208-263-9080
Mailing Address - Fax:208-255-1695
Practice Address - Street 1:1319 HIGHWAY 2 STE A
Practice Address - Street 2:
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-2729
Practice Address - Country:US
Practice Address - Phone:208-263-9080
Practice Address - Fax:208-255-1695
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-23
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP5984183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID002464600Medicaid