NPI Code Details Logo

NPI 1376627596

NPI 1376627596 : ARNZEN SUPER DRUG, INC. : KAMIAH, ID

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1376627596
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    ARNZEN SUPER DRUG, INC. 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    10/24/2006
-----------------------------------------------------
    Last Update Date     |    12/12/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    318 MAIN STREET BOX 787
-----------------------------------------------------
    City                 |    KAMIAH
-----------------------------------------------------
    State                |    ID
-----------------------------------------------------
    Zip                  |    83536
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    208-935-2301
-----------------------------------------------------
    Fax                  |    208-935-2477
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    318 MAIN STREET BOX 787
-----------------------------------------------------
    City                 |    KAMIAH
-----------------------------------------------------
    State                |    ID
-----------------------------------------------------
    Zip                  |    83536-0787
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    208-935-2301
-----------------------------------------------------
    Fax                  |    208-935-2477
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    OWNER
-----------------------------------------------------
    Name                 |    MR. ROD F ARNZEN 
-----------------------------------------------------
    Credential           |    RPH
-----------------------------------------------------
    Telephone            |    208-962-3401
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    332B00000X
-----------------------------------------------------
    Taxonomy Name        |    Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    3336C0003X
-----------------------------------------------------
    Taxonomy Name        |    Community/Retail Pharmacy
-----------------------------------------------------
    License Number       |    315CP
-----------------------------------------------------
    License Number State |    ID
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.