| NPI | 1255329405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR F ALLEN Owner Pharmacist In Charge 208-465-7000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: ID 800CP) |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2019-01-15 |