Organization
COMMUNITY COUNCIL OF IDAHO, INC
Active
Parent organization
COMMUNITY COUNCIL OF IDAHO, INC
Other names
Community Family Clinic Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMUNITY COUNCIL OF IDAHO, INC
Authorized official
TROY COULSON (PHARMACY DIRECTOR)
(208) 470-7979
Entity
Organization
Contact information
Practice address
1491 PARKWAY DR, BLACKFOOT, ID 83221-1667
(208) 435-2379
(833) 726-1877
Mailing address
2100 ALAN ST, IDAHO FALLS, ID 83404-5801
(208) 470-7979
(888) 626-5817
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
07/27/2022
Last updated
11/15/2023
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