| NPI | 1447385893 |
|---|---|
| Doing Business As | IDAHO DRUG |
| Entity Type | Organization |
| Authorized Contact | SHANE PERMANN Co Owner 208-745-6831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: ID 2171RP) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2016-04-26 |