Healthcare Provider Details
I. General information
NPI: 1811473119
Provider Name (Legal Business Name): FAMILY HEALTH SERVICES CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/19/2018
Last Update Date: 07/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
402 6TH ST
RUPERT ID
83350-1619
US
IV. Provider business mailing address
794 EASTLAND DR
TWIN FALLS ID
83301-6856
US
V. Phone/Fax
- Phone: 208-650-7941
- Fax:
- Phone: 208-734-3312
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AARON
JAMES
HOUSTON
Title or Position: CEO
Credential:
Phone: 208-734-3312