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General NPI Number Information
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NPI Number | 1760386635
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Entity Type | Organization
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Legal Business Name | IDAHO PHARMACY RETAIL
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Dates
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Enumeration Date | 10/05/2026
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 8854 W EMERALD ST STE 140
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City | BOISE
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State | ID
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Zip | 83704-4845
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Country | US
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Telephone | 208-229-5539
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Fax | 208-485-7400
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Provider Business Mailing Address
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Address Line | 1079 S ANCONA AVE STE 140
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City | EAGLE
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State | ID
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Zip | 83616-5539
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Country | US
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Telephone | 208-229-5539
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Fax | 208-485-7400
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | JAMES J HUNT
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Credential | PHARMD
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Telephone | 208-229-5539
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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 | NULL
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