NPI | 1386106953 |
---|---|
Doing Business As | STAR MARKET PHARMACY #3696 |
Entity Type | Organization |
Authorized Contact | KATHY GIANNAKOPOULOS Manager, Enrollments 208-395-3954 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
Enumeration Date | 2019-04-03 |
Last Update Date | 2024-07-31 |