Organization
DEBLAQUIERE ENTERPRISES, INC.
Active
Other names
White Cross Pharmacy LTC
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD ALLAN DE BLAQUIERE PHARMD (PRESIDENT)
(208) 610-0752
Entity
Organization
Contact information
Practice address
1319 HWY 2, SUITE A, SANDPOINT, ID 83864
(208) 263-9080
(208) 255-1695
Mailing address
1319 HWY 2, SUITE A, SANDPOINT, ID 83864
(208) 263-9080
(208) 255-1695
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807059400
—
ID
Enumeration date
05/07/2020
Last updated
05/07/2020
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