| NPI | 1104584739 |
|---|---|
| Other Name | SANDPOINT SUPER DRUG CLINICAL SERVICES |
| Entity Type | Organization |
| Authorized Contact | SCOTT PORTER Authorized Official 208-263-1408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 3336C0002X Pharmacy, Clinic Pharmacy |
| Enumeration Date | 2021-12-01 |
| Last Update Date | 2022-03-24 |