NPI age
15 years
Enumerated 2010-12-29
Across 397 active pharmacy providers in Idaho.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 | 2127936 | PK |
| 05 (ID) | 1740584051 |
Multi-provider organization. 1 individual provider on file at this primary address.
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