Organization
SUNNYSIDE DRUG
Active
Organization
SUNNYSIDE DRUG
Active
Parent organization
OSBURN DRUG COMPANY
Organization subpart
Yes
Provider details
NPI number
Legal business name
OSBURN DRUG COMPANY
Authorized official
RON LAVIGNE (PRESIDENT)
(208) 556-1139
Entity
Organization
Contact information
Practice address
805 E MULLAN AVE, OSBURN, ID 83849
(208) 556-1139
Mailing address
805 E MULLAN AVE, OSBURN, ID 83849
(208) 556-1139
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
13-02354489
ID
Other
Enumeration date
12/01/2008
Last updated
12/01/2008
Update your record
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