| NPI | 1518401512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT A MYERS President 208-419-0613 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy Compounding Pharmacy (Licence: ID OSF42972) |
| Enumeration Date | 2016-12-09 |
| Last Update Date | 2016-12-09 |