NPI | 1396792842 |
---|---|
Doing Business As | OSCO PHARMACY #0047 |
Entity Type | Organization |
Authorized Contact | KATHY GIANNAKOPOULOS Enrollment Manager 208-395-3954 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MT PHA-PHR-LIC-14921) |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: WY NR-51267) |
333600000X Pharmacy | |
Enumeration Date | 2006-05-30 |
Last Update Date | 2020-04-01 |