| NPI | 1730351081 |
|---|---|
| Doing Business As | IDAHO STATE UNIVERSITY STUDENT HEALTH CENTER PHARMACY |
| Entity Type | Organization |
| Authorized Contact | GINA DAVIS Pharmacy Manager 208-282-3407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy, Clinic Pharmacy (Licence: ID 349cp) |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2012-02-03 |