| NPI | 1376921254 |
|---|---|
| Doing Business As | PAVILIONS PHARMACY |
| Entity Type | Organization |
| Authorized Contact | KATHY GIANNAKOPOULOS Enrollments Manager 208-395-3954 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| Enumeration Date | 2015-05-12 |
| Last Update Date | 2020-04-24 |