| NPI | 1285635169 |
|---|---|
| Doing Business As | PHARMACY SHOP |
| Entity Type | Organization |
| Authorized Contact | ROBERT NATHAN MILLER President 208-785-3510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: ID 1907CP) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2008-05-22 |