| NPI | 1902069172 |
|---|---|
| Doing Business As | MEDICINE SHOPPE |
| Entity Type | Organization |
| Authorized Contact | KENT JENSEN Pharmacist 208-733-9242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: ID 1260CP) |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: ID 1260CP) |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: ID 1260CP) | |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2008-07-08 |