| NPI | 1164451126 |
|---|---|
| Doing Business As | TOM THUMB PHARMACY #3579 |
| Entity Type | Organization |
| Authorized Contact | KATHY GIANNAKOPOULOS Enrollments Manager 208-395-3954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy (Licence: TX 22125) | |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2024-07-05 |