Organization
OLSON'S MODERN DRUG CO.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HAROLD A OLSON (OWNER-PHARMACIST)
(208) 847-0536
Entity
Organization
Contact information
Practice address
762 WASHINGTON ST, MONTPELIER, ID 83254-1422
(208) 847-0536
(208) 847-1578
Mailing address
762 WASHINGTON ST, MONTPELIER, ID 83254-1422
(208) 847-0536
(208) 847-1578
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
476CP
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002683500
—
ID
Enumeration date
01/24/2006
Last updated
12/18/2008
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