# DJ GARDEN VALLEY PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Medicap Pharmacy 8427
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700565439
- **Authorized official:** DEVIN R TRONE PHARMD (PRESIDENT)
- **Authorized official phone:** (208) 288-1496

## Contact information

- **Practice address:** 284 VILLAGE CIR STE 100, GARDEN VALLEY, ID 83622-8038
- **Practice address phone:** (208) 901-8006
- **Practice address fax:** (208) 901-8007
- **Mailing address:** 2790 W CHERRY LN STE 100, MERIDIAN, ID 83642-1102
- **Mailing address phone:** (208) 901-8006
- **Mailing address fax:** (208) 901-8007

## Taxonomy

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

## Other

- **Enumeration date:** 07/11/2023
- **Last updated:** 07/11/2023