Organization
FOSTER HOLDINGS LTD
Active
Other names
Well Life Boundary Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF FOSTER (OWNER)
(208) 267-4004
Entity
Organization
Contact information
Practice address
6603 MAIN ST, BONNERS FERRY, ID 83805-8522
(208) 267-4004
(208) 267-7405
Mailing address
6603 MAIN ST, BONNERS FERRY, ID 83805-8522
(208) 267-4004
(208) 267-7405
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1386RP
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002802500
—
ID
01
—
2021436
PK
—
05
—
805978900
—
ID
Enumeration date
08/31/2006
Last updated
02/03/2016
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