| NPI | 1396732244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEIL STODDARD Owner Pharmacist 208-356-6534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| 333600000X Pharmacy (Licence: ID 1772CP) | |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2020-08-22 |