NPI age
20 years
Enumerated 2005-05-31
Across 7 active pharmacy providers in Idaho.
5 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 002646000 | |
| 05 (ID) | 002645900 |
Multi-provider organization. 5 individual providers on file at this primary address.
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