NPI age
11 years
Enumerated 2014-11-12
Across 397 active pharmacy providers in Idaho.
4 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 1720484140 | |
| 01 | 2148915 | PK |
Doing-business-as, former, and alternate names recorded by NPPES.
Multi-provider organization. 4 individual providers on file at this primary address.
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