Organization
DEBLAQUIERE ENTERPRISES INC
Active
Other names
WHITE CROSS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON MCGLASHAN (CORP. SECRETARY)
(208) 448-1633
Entity
Organization
Contact information
Practice address
1319 HIGHWAY 2 STE A, SANDPOINT, ID 83864-2729
(208) 263-9080
(208) 255-1695
Mailing address
1319 HIGHWAY 2, STE A, SANDPOINT, ID 83864-2711
(208) 263-9080
(208) 255-1695
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1786RP
ID
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002464700
—
ID
01
—
2021876
PK
—
05
—
807059400
—
ID
Enumeration date
10/06/2005
Last updated
12/04/2019
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