# MIKES LTC PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mike's Long Term Care Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972398063
- **Authorized official:** CHAD MICHAEL MERRILL (OWNER)
- **Authorized official phone:** (208) 525-8700

## Contact information

- **Practice address:** 180 S HOLMES AVE STE B, IDAHO FALLS, ID 83401-3945
- **Practice address phone:** (208) 525-8728
- **Mailing address:** 180 S HOLMES AVE STE B, IDAHO FALLS, ID 83401-3945
- **Mailing address phone:** (208) 525-8728
- **Mailing address fax:** (208) 525-5254

## Taxonomy

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

## Other

- **Enumeration date:** 04/10/2025
- **Last updated:** 08/03/2026