Healthcare Provider Details

I. General information

NPI: 1396464566
Provider Name (Legal Business Name): CRX HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2022
Last Update Date: 12/19/2022
Certification Date: 12/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

173 W 4TH ST
KUNA ID
83634-2087
US

IV. Provider business mailing address

173 W 4TH ST
KUNA ID
83634-2087
US

V. Phone/Fax

Practice location:
  • Phone: 208-922-4400
  • Fax: 208-922-4499
Mailing address:
  • Phone: 208-922-4400
  • Fax: 208-922-4499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ERIC SCHLERF
Title or Position: PHARMACIST/OWNER
Credential: PHARMD
Phone: 208-922-4400