| NPI | 1487117636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCUS HURST Pharmacy Director 208-745-9201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0002X Pharmacy Clinic Pharmacy | |
| Enumeration Date | 2019-04-12 |
| Last Update Date | 2025-07-03 |