Provider Demographics
NPI:1023846904
Name:ARNAUTOVIC, ALDA (PHARMD)
Entity type:Individual
Prefix:
First Name:ALDA
Middle Name:
Last Name:ARNAUTOVIC
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 1:4903 W RIVA CAPRI ST
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83646-1797
Mailing Address - Country:US
Mailing Address - Phone:208-890-9350
Mailing Address - Fax:
Practice Address - Street 1:1653 S VISTA AVE
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705-3172
Practice Address - Country:US
Practice Address - Phone:208-331-1953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-23
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID1961764183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist