| NPI | 1972293413 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER RAY JOHNSON President 208-734-8177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2023-05-09 |
| Last Update Date | 2023-05-11 |