| NPI | 1881575496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SETH HASLAM Owner/Staff Pharmacist 208-851-1561 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2025-09-10 |
| Last Update Date | 2025-09-22 |