| NPI | 1386747558 |
|---|---|
| Doing Business As | WELL LIFE LATAH PHARMACY |
| Entity Type | Organization |
| Authorized Contact | JEFF FOSTER Owner 208-267-4004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WA PHAR.CF.60586627) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2017-01-18 |