| NPI | 1508365958 |
|---|---|
| Doing Business As | MOUNTAIN PHARMACY |
| Entity Type | Organization |
| Authorized Contact | PHILLIP ROMAN BURK Owner 208-855-0701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: ID 47034RP) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2018-02-12 |
| Last Update Date | 2020-10-07 |