Customedica Pharmacy INC

Practice location

Address

149 W State St STE 101, Eagle, ID 83616-4911

Phone

(208) 939-8008

Fax

(208) 938-1067

Mailing address

149 W State St Suite 101, Eagle, ID 83616-4901

Authorised official

Name

Shah Afshar

Title

Cheif Pharmacist

Phone

(208) 939-8008

Registered specialties (4)

Registry record

NPI

1508162454

Entity type

Organization

NPI issued

9 Feb 2011

Record last updated

17 Aug 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.