Organization
DEBLAQUIERE ENTERPRISES, INC.
Active
Other names
White Cross Pharmacy Priest River
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON MCGLASHAN (CORP. SECRETARY)
(208) 448-1633
Entity
Organization
Contact information
Practice address
5453 HIGHWAY 2, PRIEST RIVER, ID 83856
(208) 448-1633
(208) 448-1728
Mailing address
PO BOX 458, PRIEST RIVER, ID 83856-0458
(208) 448-1633
(208) 448-1728
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002464600
—
ID
05
—
002464700
—
ID
Enumeration date
10/04/2005
Last updated
03/07/2023
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