NPI | 1023065588 |
---|---|
Doing Business As | SHAWS PHARMACY #0117 |
Entity Type | Organization |
Authorized Contact | KATHY GIANNAKOPOULOS Enrollment Manager 208-395-3932 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: VT 038.0093611) |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
333600000X Pharmacy | |
Enumeration Date | 2006-05-30 |
Last Update Date | 2024-07-10 |