| NPI | 1467425249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIM BROWN Pharmacist/Owner 208-664-6664 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ID 782CP) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: ID 782CP) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2015-09-14 |