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Organization

ST LUKE'S REG MED CTR EMPLOYEE OUTPT PHARMACY

Active
Other names
St Luke's EOP
Organization subpart
No

Provider details

NPI number
Authorized official
JAMES W NORMARK RPH (OPERATION MANAGER, OUTPT PHARMACY)
(208) 381-4354
Entity
Organization

Contact information

Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-4353
(208) 381-4355
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-4353
(208) 381-4355

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
1019CP
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1019CP
PHARMACY LICENSE
ID
01
1305653
NABP
Enumeration date
08/12/2005
Last updated
08/22/2020
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