Provider Demographics
NPI:1730803271
Name:IDAHO PRIORITY PRESCRIPTIONS
Entity type:Organization
Organization Name:IDAHO PRIORITY PRESCRIPTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:208-249-8414
Mailing Address - Street 1:845 S SUB STATION RD STE B
Mailing Address - Street 2:
Mailing Address - City:EMMETT
Mailing Address - State:ID
Mailing Address - Zip Code:83617-9430
Mailing Address - Country:US
Mailing Address - Phone:208-249-8414
Mailing Address - Fax:
Practice Address - Street 1:845 S SUB STATION RD STE B
Practice Address - Street 2:
Practice Address - City:EMMETT
Practice Address - State:ID
Practice Address - Zip Code:83617-9430
Practice Address - Country:US
Practice Address - Phone:208-866-4739
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-28
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy