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Organization

MIKE'S LTC PHARMACY, LLC

Active
Other names
Mike's Long Term Care Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
JUSTIN MERRILL PHARMD (OWNER)
(208) 525-8728
Entity
Organization

Contact information

Practice address
180 S HOLMES AVE STE B, IDAHO FALLS, ID 83401-3945
(208) 525-8728
Mailing address
180 S HOLMES AVE STE B, IDAHO FALLS, ID 83401-3945
(208) 525-8728
(208) 525-5254

Taxonomy

Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary

Other

Enumeration date
04/10/2025
Last updated
10/08/2025
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