Organization
FAMILY HEALTH SERVICES CORPORATION
Active
Other names
FHS Burley Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY BLACKWOOD (CREDENTIALING)
(208) 737-6718
Entity
Organization
Contact information
Practice address
1309 BENNETT AVE, BURLEY, ID 83318-2676
(208) 650-7854
(208) 578-0291
Mailing address
794 EASTLAND DR, TWIN FALLS, ID 83301-6856
(208) 734-5036
(208) 734-5036
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
39954RP
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2153044
PK
—
Enumeration date
07/07/2015
Last updated
05/13/2021
About Stedi
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