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General NPI Number Information
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NPI Number | 1770464711
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Entity Type | Organization
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Legal Business Name | WELLNESS PEPTIDES
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Dates
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Enumeration Date | 09/08/2025
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 324 BOISE ST
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City | MIDDLETON
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State | ID
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Zip | 83644-5576
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Country | US
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Telephone | 208-760-0557
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Fax | 986-200-4697
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Provider Business Mailing Address
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Address Line | 324 BOISE ST
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City | MIDDLETON
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State | ID
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Zip | 83644-5576
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Country | US
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Telephone | 208-760-0557
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Fax | 986-200-4697
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | DR. CRAIG SMITH
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Credential | PHARM D
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Telephone | 208-760-0557
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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