NPI | 1154532794 |
---|---|
Entity Type | Organization |
Authorized Contact | MARY F. SNIDER Pharmacist In Charge 208-265-1093 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: ID 1402CP) |
Enumeration Date | 2007-05-25 |
Last Update Date | 2020-08-22 |