| NPI | 1043629397 |
|---|---|
| Doing Business As | TETON PHARMACY ON BROADWAY |
| Entity Type | Organization |
| Authorized Contact | PHILIP HARPER Owner 208-360-1317 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2014-08-11 |
| Last Update Date | 2019-05-03 |