| NPI | 1336747948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL SCOTT FUCHS Member/Rph 208-734-7373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| 3336H0001X Pharmacy Home Infusion Therapy Pharmacy | |
| 3336L0003X Pharmacy Long Term Care Pharmacy | |
| 3336M0002X Pharmacy Mail Order Pharmacy | |
| Enumeration Date | 2020-10-15 |
| Last Update Date | 2020-10-15 |