| NPI | 1083794598 |
|---|---|
| Other Name | PHARMACY |
| Entity Type | Organization |
| Authorized Contact | BRIAN LANNIE CHECKETTS CFO And Board Member 208-367-2844 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy (Licence: ID 2) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2024-10-17 |