Basic Information
| Provider Information | |||||||||
| NPI: | 1265424105 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FORCE | ||||||||
| FirstName: | REX | ||||||||
| MiddleName: | W | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHARMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | ISU BOX 8357 | ||||||||
| Address2: | 465 MEMORIAL DRIVE | ||||||||
| City: | POCATELLO | ||||||||
| State: | ID | ||||||||
| PostalCode: | 832090001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2082824508 | ||||||||
| FaxNumber: | 2082824818 | ||||||||
| Practice Location | |||||||||
| Address1: | ISU BOX 8357 | ||||||||
| Address2: | 465 MEMORIAL DRIVE | ||||||||
| City: | POCATELLO | ||||||||
| State: | ID | ||||||||
| PostalCode: | 832090001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2082824508 | ||||||||
| FaxNumber: | 2082824818 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1835P1200X | P5007 | ID | Y | Pharmacy Service Providers | Pharmacist | Pharmacotherapy |
No ID Information.