Organization
DEBLAQUIERE ENTERPRISES INC
Active
Other names
White Cross Pharmacy - Spirit Lake
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD ALLAN DE BLAQUIERE PHARMD (PRESIDENT)
(208) 610-0752
Entity
Organization
Contact information
Practice address
31964 N 5TH AVE, SPIRIT LAKE, ID 83869
(208) 623-8485
(208) 623-3400
Mailing address
PO BOX 510, SPIRIT LAKE, ID 83869-0510
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477973832
—
ID
Enumeration date
04/23/2014
Last updated
04/17/2023
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