NPI age
19 years
Enumerated 2006-07-02
Across 397 active pharmacy providers in Idaho.
3 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 003486600 | |
| 01 | 2020942 | PK |
| 05 (ID) | 1578592531 |
Doing-business-as, former, and alternate names recorded by NPPES.
Multi-provider organization. 3 individual providers on file at this primary address.
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