# MAAG PRESCRIPTION CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MAAG PRESCRIPTION AND MEDICAL SUPPLY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134783202
- **Authorized official:** KATHLEEN CAROL MAAG (BOARD OF DIRECTION, VP, TREASURER)
- **Authorized official phone:** (208) 233-2063

## Contact information

- **Practice address:** 333 W CENTER ST, POCATELLO, ID 83204-3243
- **Practice address phone:** (208) 233-2063
- **Practice address fax:** (208) 233-6158
- **Mailing address:** PO BOX 115, POCATELLO, ID 83204-0115
- **Mailing address phone:** (208) 233-2063
- **Mailing address fax:** (208) 233-6158

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 04/24/2019
- **Last updated:** 04/24/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 002488900 | — | ID |