Provider Demographics
NPI:1306607593
Name:EILMANN, MKCADE KNOX (PHARMD)
Entity type:Individual
Prefix:
First Name:MKCADE
Middle Name:KNOX
Last Name:EILMANN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-3236
Mailing Address - Country:US
Mailing Address - Phone:253-324-9782
Mailing Address - Fax:
Practice Address - Street 1:600 N CECIL RD
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-6200
Practice Address - Country:US
Practice Address - Phone:208-262-2788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP10795183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist