Provider Demographics
NPI:1881981819
Name:CASABONNE, FRANCOIS ROBERT (B SC)
Entity type:Individual
Prefix:
First Name:FRANCOIS
Middle Name:ROBERT
Last Name:CASABONNE
Suffix:
Gender:M
Credentials:B SC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3614 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83703-5218
Mailing Address - Country:US
Mailing Address - Phone:208-426-9639
Mailing Address - Fax:
Practice Address - Street 1:3614 W STATE ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83703-5218
Practice Address - Country:US
Practice Address - Phone:208-426-9639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP4194183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist