1918 Winter Street Operating Co LLC

NPI #1154192946 in Pocatello, Idaho

Provider Information

NPI Number
1154192946
Entity Type
Organization
Organization Name
1918 Winter Street Operating Co LLC
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Jan 11, 2024
Last Updated
Jul 24, 2024

Practice Location

Address
330 E BENTON ST
State
Idaho
ZIP Code
83201-6526
Phone
(208) 233-0651

Authorized Official

Name
KEVIN MCNAMARA
Title
AUTHORIZED PERSON
Phone
(603) 354-4619

Specialties & Taxonomy Codes

Specialty
Durable Medical Equipment & Medical Supplies
Pharmacy
Pharmacy - Community/Retail PharmacyCommunity/Retail Pharmacy

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