Organization
SANDPOINT SUPER DRUG CLINICAL
Active
Other names
Sandpoint Super Drug Clinical Services
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT PORTER PHARMD (AUTHORIZED OFFICIAL)
(208) 263-1408
Entity
Organization
Contact information
Practice address
604 N FIFTH AVE, SANDPOINT, ID 83864-1520
(208) 263-1408
Mailing address
604 N FIFTH AVE, SANDPOINT, ID 83864-1520
(208) 263-1408
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
3336C0002X
Clinic Pharmacy
—
—
Other
Enumeration date
12/01/2021
Last updated
03/24/2022
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