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General NPI Number Information
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NPI Number | 1215035969
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Entity Type | Organization
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Legal Business Name | LARRY'S FAMILY PHARMACY, INC.
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 217 SOUTH STATE ST.
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City | PRESTON
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State | ID
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Zip | 83263
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Country | US
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Telephone | 208-852-0163
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Fax | 208-852-1847
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Provider Business Mailing Address
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Address Line | 217 SOUTH STATE ST.
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City | PRESTON
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State | ID
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Zip | 83263
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Country | US
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Telephone | 208-852-0163
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Fax | 208-852-1847
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Authorized Official
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Title or Position | OWNER PHARMACIST
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Name | MR. LARRY DURRANT
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Credential | R.P.H
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Telephone | 435-563-6262
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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 | 1336CP
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | P4557
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 1336CP
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License Number State | ID
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