| NPI | 1750817870 |
|---|---|
| Doing Business As | PAVILIONS PHARMACY #2412 |
| Entity Type | Organization |
| Authorized Contact | TIFFANY ELIOPULOS Assistant Manager, Enrollments 208-395-3906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CA PHY55613) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2018-11-02 |