Bear Lake Drug LLC
NPI #1861806820 in Montpelier, Idaho
Provider Information
- NPI Number
- 1861806820
- Entity Type
- Organization
- Organization Name
- Bear Lake Drug LLC
- Primary Specialty
- Pharmacy - Community/Retail Pharmacy
- Enumeration Date
- Jun 18, 2014
- Last Updated
- Jan 18, 2017
Practice Location
- Address
- 836 WASHINGTON ST
- City
- Montpelier
- State
- Idaho
- ZIP Code
- 83254-1423
- Phone
- (208) 847-1421
Authorized Official
- Name
- CASEY HUMPHERYS
- Title
- PHARMD
- Phone
- (208) 847-1421
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacy |
| Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy |
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