Organization
TYLERS PRESCRIPTION PHARMACY
Active
Other names
TYLERS GEM PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT TYLER (OWNER)
(208) 365-6600
Entity
Organization
Contact information
Practice address
540 N MOFFATT AVE, EMMETT, ID 83617-2733
(208) 365-6600
Mailing address
540 N MOFFATT AVE, EMMETT, ID 83617-2733
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
533CP
ID
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1302924
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/30/2006
Last updated
02/08/2008
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