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General NPI Number Information
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NPI Number | 1063514594
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Entity Type | Organization
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Legal Business Name | LEMP'S APOTHECARY, INC.
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Dates
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Enumeration Date | 09/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 222 N 2ND ST SUITE 101
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City | BOISE
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State | ID
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Zip | 83702-6109
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Country | US
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Telephone | 208-342-5691
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Fax | 208-342-4094
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Provider Business Mailing Address
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Address Line | 222 N 2ND ST SUITE 101
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City | BOISE
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State | ID
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Zip | 83702-6109
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Country | US
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Telephone | 208-342-5691
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Fax | 208-342-4094
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Authorized Official
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Title or Position | OWNER
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Name | GERALD VEACH WILBURN
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Credential |
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Telephone | 208-342-5691
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 524CP
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License Number State | ID
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