# KEYMED INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Snake River Long Term Care Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487698171
- **Authorized official:** MR. DAVID MILLS (PRESIDENT)
- **Authorized official phone:** (208) 233-2444

## Contact information

- **Practice address:** 3607 POLE LINE RD, POCATELLO, ID 83201-5531
- **Practice address phone:** (208) 233-2444
- **Practice address fax:** (208) 233-3439
- **Mailing address:** 3607 POLE LINE RD, POCATELLO, ID 83201-5531
- **Mailing address phone:** (208) 233-2444
- **Mailing address fax:** (208) 233-3439

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | 1901LS | ID | — |
| 3336L0003X | Long Term Care Pharmacy | 44701LS | ID | Yes |

## Other

- **Enumeration date:** 06/15/2006
- **Last updated:** 12/13/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 807012000 | — | ID |