| NPI | 1871680934 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN STAYNER PARRISH Pharmacist 208-420-0598 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist Ambulatory Care |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: ID 1046CP) |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2021-02-19 |