| NPI | 1972398063 |
|---|---|
| Doing Business As | MIKE'S LONG TERM CARE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | JUSTIN MERRILL Owner 208-525-8728 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2025-04-10 |
| Last Update Date | 2025-10-08 |