Organization
AMERICAN DRUG STORES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
2707 E DIVISION ST, DIAMOND, IL 60416
(779) 340-9360
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3999
(208) 395-3954
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
12/22/2023
Last updated
02/07/2025
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