| NPI | 1205297744 |
|---|---|
| Doing Business As | MIKE'S PHARMACY DME |
| Entity Type | Organization |
| Authorized Contact | MICHAEL MERRILL Owner/Pharmacist 208-525-8700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: ID 703rp) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: ID 703rp) |
| Enumeration Date | 2016-03-11 |
| Last Update Date | 2016-03-11 |