Organization
MAAG PRESCRIPTION CENTER LLC
Active
Other names
MAAG PRESCRIPTION AND MEDICAL SUPPLY
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN CAROL MAAG (BOARD OF DIRECTION, VP, TREASURER)
(208) 233-2063
Entity
Organization
Contact information
Practice address
333 W CENTER ST, POCATELLO, ID 83204-3243
(208) 233-2063
(208) 233-6158
Mailing address
PO BOX 115, POCATELLO, ID 83204-0115
(208) 233-2063
(208) 233-6158
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002488900
—
ID
Enumeration date
04/24/2019
Last updated
04/24/2019
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