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Organization
DEBLAQUIERE ENTERPRISES, INC.
Active
Organization
DEBLAQUIERE ENTERPRISES, INC.
Active
Other names
White Cross Pharmacy LTC
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD ALLAN DE BLAQUIERE PHARMD (PRESIDENT)
(208) 610-0752
Entity
Organization
Contact information
Practice address
1319 HWY 2, SUITE A, SANDPOINT, ID 83864
(208) 263-9080
(208) 255-1695
Mailing address
1319 HWY 2, SUITE A, SANDPOINT, ID 83864
(208) 263-9080
(208) 255-1695
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807059400
—
ID
Enumeration date
05/07/2020
Last updated
05/07/2020
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