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JACKS PHARMACY INC

Medical Equipment Supplier Yellow Pages

St Maries, Idaho

Provider NPI: 1518967710

Organization Information:
Organization Name:  JACKS PHARMACY INC


Practice Location:
103 E COLLEGE AVE  ST MARIES, ID 83861 US
Tel: 208-245-4578  Fax: --

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


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y3336C0003XSuppliers
Pharmacy
Community/Retail Pharmacy
ID1368CP

Other Provider Identifiers:

IssuerNumberStateType
002494500ID05
002494400ID05
NCPDP1303483ID01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




JOBS ID - Page 1



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