| NPI | 1609931039 |
|---|---|
| Doing Business As | KJ'S PHARMACY |
| Entity Type | Organization |
| Authorized Contact | THOMAS GILL WADSWORTH Owner 208-733-9242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: ID 37753RP) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2016-03-24 |