Organization
LIFEFILL III, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL NAMETH (EVP, CLOUD AND SPECIALTY PHARMACY)
(646) 201-9585
Entity
Organization
Contact information
Practice address
3597 E MONARCH SKY LN. SUITE 240, OFC 215, MERIDIAN, ID 83646
(208) 247-3184
Mailing address
1407 BROADWAY RM 1910, NEW YORK, NY 10018-2874
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6181221
BOARD OF PHARMACY
ID
Enumeration date
07/31/2026
Last updated
07/31/2026
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