Organization
K2RED L.L.C.
Active
Other names
DICK'S PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL SCOTT FUCHS RPH (MEMBER)
(208) 734-7373
Entity
Organization
Contact information
Practice address
526 SHOUP AVE W STE K, TWIN FALLS, ID 83301-5050
(208) 734-7373
(208) 734-7389
Mailing address
526 SHOUP AVE W STE K, TWIN FALLS, ID 83301-5050
(208) 734-7373
(208) 734-7389
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
1307CP
ID
3336C0003X
Community/Retail Pharmacy
Primary
1307CP
ID
3336S0011X
Specialty Pharmacy
1307CP
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805156900
—
ID
05
—
805182800
—
ID
Enumeration date
09/20/2006
Last updated
04/25/2008
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