| NPI | 1265559314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN BROETJE Administrative Director 208-442-2812 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336I0012X Pharmacy Institutional Pharmacy (Licence: ID 539-HP) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2020-08-22 |