Organization
K2RED L.L.C.
Active
Other names
MEDICAL OFFICE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL SCOTT FUCHS RPH (MEMBER)
(208) 737-2620
Entity
Organization
Contact information
Practice address
630 ADDISON AVE W STE 120, TWIN FALLS, ID 83301-5475
(208) 737-2620
(208) 737-2621
Mailing address
630 ADDISON AVE W STE 120, TWIN FALLS, ID 83301-5475
(208) 737-2620
(208) 737-2621
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
1328CP
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805111800
—
ID
Enumeration date
10/03/2006
Last updated
04/25/2008
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