| NPI | 1982159133 |
|---|---|
| Doing Business As | CUSTOMEDICA PHARMACY NORTH END |
| Entity Type | Organization |
| Authorized Contact | SHAH AFSHAR President 208-939-8008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: ID 43415RP) |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2016-08-17 |
| Last Update Date | 2016-11-07 |