Organization
KOHAL PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONY WRIGHT (OWNER)
(208) 682-4015
Entity
Organization
Contact information
Practice address
504 NORTH DIVISION AVE, PINEHURST, ID 83850
(208) 682-4015
(208) 682-3939
Mailing address
PO BOX 400, PINEHURST, ID 83850-0400
(208) 682-4015
(208) 682-3939
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
857CP
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002528000
—
ID
Enumeration date
03/13/2007
Last updated
07/01/2024
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