| NPI | 1609800937 |
|---|---|
| Doing Business As | EASTGATE DRUG STORE |
| Entity Type | Organization |
| Authorized Contact | COREY SMITH President 208-522-1243 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: ID 1010CP) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2020-08-22 |