Organization
LIFES CHOICES INC
Active
Other names
LIFES DOORS HCS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MARY LANGENFELD RN PHD (CEO)
(208) 947-0967
Entity
Organization
Contact information
Practice address
420 S ORCHARD ST, BOISE, ID 83705-1238
(208) 947-0967
(208) 947-0967
Mailing address
420 S ORCHARD ST, BOISE, ID 83705-1238
(208) 947-0967
(208) 947-0967
Taxonomy
Speciality
Code
Description
License number
State
3336S0011X
Specialty Pharmacy
Primary
1931LS
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1307544
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
807140400
—
ID
Enumeration date
03/29/2006
Last updated
05/04/2010
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