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General NPI Number Information
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NPI Number | 1013540814
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Entity Type | Organization
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Legal Business Name | SALMON PHARMACY, LLC
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Dates
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Enumeration Date | 02/20/2020
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Last Update Date | 07/02/2020
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Provider Practice Location Address
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Address Line | 309 MAIN STREET
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City | SALMON
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State | ID
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Zip | 83467
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Country | US
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Telephone | 208-742-3784
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Fax | 208-742-6363
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Provider Business Mailing Address
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Address Line | 309 MAIN STREET
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City | SALMON
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State | ID
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Zip | 83467
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Country | US
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Telephone | 208-742-3784
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Fax | 208-742-6363
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | ERIC ANDERSON
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Credential | PHARMD
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Telephone | 208-742-3784
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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