Medicine Man Compounding Center LLC
NPI #1659907962 in Post Falls, Idaho
Provider Information
- NPI Number
- 1659907962
- Entity Type
- Organization
- Organization Name
- Medicine Man Compounding Center LLC
- Primary Specialty
- Pharmacy - Compounding Pharmacy
- Enumeration Date
- Mar 18, 2020
- Last Updated
- Mar 18, 2020
Practice Location
- Address
- 565 N VEST ST
- City
- Post Falls
- State
- Idaho
- ZIP Code
- 83854-7066
- Phone
- (208) 773-2499
Authorized Official
- Name
- DONALD RAY SMITH, RPH
- Title
- MANAGING PARNER
- Phone
- (208) 661-5199
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacy - Compounding Pharmacy — Compounding Pharmacy |
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