Organization
KOHAL PHARMACY INC
Active
Parent organization
KOHAL PHARMACY INC
Other names
Kohal Pharmacy Wallace
Organization subpart
Yes
Provider details
NPI number
Legal business name
KOHAL PHARMACY INC
Authorized official
TONY WRIGHT (OWNER)
(208) 220-6150
Entity
Organization
Contact information
Practice address
800 BANK ST, WALLACE, ID 83873-2306
(208) 752-1833
(208) 752-1831
Mailing address
800 BANK ST, WALLACE, ID 83873-2306
(208) 752-1833
(208) 752-1831
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821750738
—
ID
Enumeration date
10/07/2021
Last updated
02/25/2022
Update your record
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