Organization
MICHAEL D MERRILL
Active
Other names
Mike's Pharmacy DME
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL MERRILL RPH (OWNER/PHARMACIST)
(208) 525-8700
Entity
Organization
Contact information
Practice address
180 S HOLMES AVE, IDAHO FALLS, ID 83401-3945
(208) 525-8700
Mailing address
180 S HOLMES AVE, IDAHO FALLS, ID 83401-3945
(208) 525-8700
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
703RP
ID
333600000X
Pharmacy
703RP
ID
Other
Enumeration date
03/11/2016
Last updated
03/11/2016
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