NPI | 1356432140 |
---|---|
Entity Type | Organization |
Authorized Contact | KATHY GIANNAKOPOULOS Enrollments Manager 208-395-3954 |
Organization Subpart ? | Yes |
Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
Additional Taxonomies | 333600000X Pharmacy |
Enumeration Date | 2006-09-27 |
Last Update Date | 2020-04-24 |