NPI | 1306882907 |
---|---|
Doing Business As | TOM THUMB PHARMACY #3652 |
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 22100) | |
Enumeration Date | 2006-06-21 |
Last Update Date | 2024-07-05 |