| NPI | 1033917810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN CRUMLEY Operations Manager 208-985-3575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy |
| Additional Taxonomies | 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy |
| 3336M0002X Pharmacy, Mail Order Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2025-03-06 |
| Last Update Date | 2025-03-24 |