Idaho Cvs Pharmacy LLC
Pharmacy in Boise, ID. Organization (NPI-2).
NPI number1265912901
StatusActive
Last updated in NPPESOct 30, 2018
Details
- NPI
- 1265912901
- Entity type
- Organization (NPI-2)
- Legal business name
- Idaho Cvs Pharmacy LLC
- Organization subpart
- No
- Enumeration date
- Aug 21, 2018
- Last updated
- Oct 30, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 333600000X | Pharmacy | – | – | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – | |
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | – | – |
Other names
- Cvs Pharmacy #11169 (Doing Business As)
Practice location
7402 W Fairview AveBoise, ID 83704-8411
Phone 208-375-4670
Mailing address
1 Cvs Dr # 1075Woonsocket, RI 02895-6146
Phone 401-765-1500
Authorized official
Susan Colbert
Sr Director
4017702751
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