Organization
OSBURN DRUG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD DALE LAVIGNE R.PH (PRESIDENT)
(208) 556-1139
Entity
Organization
Contact information
Practice address
805 MULLAN AVE., OSBURN, ID 83849
(208) 556-1139
(208) 556-7311
Mailing address
P.O. BOX 2170, OSBURN, ID 83849
(208) 556-1139
(208) 556-7311
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
CP245
ID
Other
Enumeration date
10/13/2006
Last updated
04/27/2010
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