Organization
SQUAD PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MALLIKA KHANDELWAL (CEO)
(610) 955-2633
Entity
Organization
Contact information
Practice address
202 N 9TH ST, BOISE, ID 83702-5734
(208) 417-5249
Mailing address
1107 BROADWAY APT 4C, NEW YORK, NY 10010-0007
(610) 955-2633
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Enumeration date
12/19/2024
Last updated
12/19/2024
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