| NPI | 1508080557 |
|---|---|
| Doing Business As | PHARMACY SHOP |
| Entity Type | Organization |
| Authorized Contact | ROBERT NATHAN MILLER Pharmacist 208-785-3510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2020-08-22 |