| NPI | 1689687261 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | K DOUGLAS CRAFTON Director Of Pharmacy 208-799-3422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: ID 1042HP) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2023-03-07 |