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General NPI Number Information
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NPI Number | 1750440046
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Entity Type | Organization
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Legal Business Name | LONDON DRUG CO INC
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 12/09/2015
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Provider Practice Location Address
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Address Line | 6 S MAIN ST
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City | GRACE
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State | ID
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Zip | 83241-0325
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Country | US
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Telephone | 208-425-3766
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Fax | 208-425-3767
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Provider Business Mailing Address
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Address Line | PO BOX 325
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City | GRACE
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State | ID
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Zip | 83241-0325
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Country | US
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Telephone | 208-425-3766
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Fax | 208-425-9010
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Authorized Official
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Title or Position | OWNER AND PRESIDENT
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Name | GREG LONDON
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Credential | RPH
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Telephone | 208-425-3766
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 572RP
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License Number State | ID
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