| NPI | 1578944054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT DOWIES Pharmacist In Charge 208-878-7455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: ID 38889RP) |
| Enumeration Date | 2015-06-10 |
| Last Update Date | 2015-11-19 |