Organization
CEDAR PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN HORNE PHARMD (PHARMACIST IN CHARGE)
(801) 809-2656
Entity
Organization
Contact information
Practice address
1309 BLUE LAKES BLVD N, TWIN FALLS, ID 83301-3310
(801) 809-2656
Mailing address
1309 BLUE LAKES BLVD N, TWIN FALLS, ID 83301-3310
(801) 809-2656
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Enumeration date
05/15/2023
Last updated
05/15/2023
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