Organization
COMMUNITY COUNCIL OF IDAHO, INC
Active
Parent organization
COMMUNITY COUNCIL OF IDAHO, INC
Other names
Community Family Clinic Pharmacy 340 B
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMUNITY COUNCIL OF IDAHO, INC
Authorized official
TROY COULSON PHARMD (PHARMACY DIRECTOR)
(208) 470-7979
Entity
Organization
Contact information
Practice address
2100 ALAN ST, IDAHO FALLS, ID 83404
(208) 470-7979
(888) 626-5817
Mailing address
2100 ALAN ST, IDAHO FALLS, ID 83404-5801
(208) 470-7979
(898) 626-5817
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
12/08/2021
Last updated
04/04/2023
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