NPI age
19 years
Enumerated 2006-06-21
Across 397 active pharmacy providers in Idaho.
2 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 | 2021426 | PK |
| 05 (ID) | 0034868 | |
| 05 (ID) | 1164468781 |
Doing-business-as, former, and alternate names recorded by NPPES.
Multi-provider organization. 2 individual providers on file at this primary address.
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