# SNAKE RIVER PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740717693
- **Authorized official:** DR. BRIAN LUNT PHARMD (PHARMACIST)
- **Authorized official phone:** (208) 240-3733

## Contact information

- **Practice address:** 4750 YELLOWSTONE AVE, CHUBBUCK, ID 83202-2336
- **Practice address phone:** (208) 240-3733
- **Mailing address:** 4750 YELLOWSTONE AVE, CHUBBUCK, ID 83202-2336
- **Mailing address phone:** (208) 240-3733

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0002X | Clinic Pharmacy | 44698RP | ID | Yes |

## Other

- **Enumeration date:** 05/22/2017
- **Last updated:** 07/21/2022