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General NPI Number Information
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NPI Number | 1144910878
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Entity Type | Organization
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Legal Business Name | NORCO, INC.
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Dates
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Enumeration Date | 05/08/2023
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Last Update Date | 05/08/2023
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Provider Practice Location Address
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Address Line | 400 W MAIN ST # 105
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City | BOISE
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State | ID
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Zip | 83702-7243
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Country | US
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Telephone | 844-819-4907
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Fax | 833-726-1971
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Provider Business Mailing Address
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Address Line | 1125 W AMITY RD
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City | BOISE
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State | ID
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Zip | 83705-5412
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Country | US
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Telephone | 208-336-1643
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | AMANDA GOTTS
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Credential |
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Telephone | 208-509-3088
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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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