NPI | 1316462393 |
---|---|
Entity Type | Organization |
Authorized Contact | LORENZO TORRES Pharmacy Enrollment Specialist 208-395-3963 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
Enumeration Date | 2017-08-10 |
Last Update Date | 2022-07-21 |