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BONNER PROFESSIONAL COMPOUNDING

Medical Equipment Supplier Yellow Pages

Sandpoint, Idaho

Provider NPI: 1154532794

Organization Information:
Organization Name:  BONNER PROFESSIONAL COMPOUNDING


Practice Location:
520 N 3RD AVE  SANDPOINT, ID 83864 US
Tel: 208-265-1093  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y3336C0004XSuppliers
Pharmacy
Compounding Pharmacy
ID1402CP

Other Provider Identifiers:

IssuerNumberStateType
NCPDS #1306718ID01
STATE LICENSE #1402CPID01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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