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KOOTENAL HEALTH

Specialty Pharmacy

Coeur D Alene, Idaho

Provider NPI: 1073835591

Organization Information:
Organization Name:  KOOTENAL HEALTH


Practice Location:
700 W IRONWOOD DR  COEUR D ALENE, ID 83814 US
Tel: 208-625-5670  Fax: --

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


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N3336S0011XSuppliers
Pharmacy
Specialty Pharmacy
N332B00000XSuppliers
Durable Medical Equipment & Medical Supplies
N333600000XSuppliers
Pharmacy
Y3336C0002XSuppliers
Pharmacy
ID1198LS

Other Provider Identifiers:

IssuerNumberStateType
1073835591ID05
PK212439801
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




PHARMACY JOBS ID - Page 1



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