State of Idaho
NPI #1750442315 in Blackfoot, Idaho
Provider Information
- NPI Number
- 1750442315
- Entity Type
- Organization
- Organization Name
- State of Idaho
- Primary Specialty
- Pharmacy
- Enumeration Date
- Dec 13, 2006
- Last Updated
- Jun 16, 2018
Practice Location
Authorized Official
- Name
- MRS. TRACEY G. SESSIONS
- Title
- ADMINISTRATIVE DIRECTOR
- Phone
- (208) 785-8406
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacy - Long Term Care Pharmacy — Long Term Care Pharmacy |
| Pharmacy |
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