| NPI | 1962581652 |
|---|---|
| Doing Business As | MEDICAL CLINIC PHARMACY |
| Entity Type | Organization |
| Authorized Contact | TYLER HIGGINS President 208-459-1503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: ID 2373RP) |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| 333600000X Pharmacy | |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2018-07-19 |