| |
570 S State St Shelley ID 83274-1470 | |
(208) 357-0473 | |
(208) 357-0498 |
Full Name | |
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Speciality | Pharmacy - Community/retail Pharmacy |
Location | 570 S State St, Shelley, Idaho |
Authorized Official Name and Position | Marcus C Hurst (PHARMACY SUPERVISOR) |
Authorized Official Contact | 2087459201 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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182 N State St Rigby ID 83442-1444 Ph: (208) 745-9201 | 570 S State St Shelley ID 83274-1470 Ph: (208) 357-0473 |
NPI Number | 1396870911 |
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Provider Enumeration Date | 02/22/2007 |
Last Update Date | 11/19/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1396870911 | NPI | - | NPPES |
1307493 | Other | NCPDP | |
1396870911 | Medicaid | ID | |
1912011 | Other | ID | IMMUNIZATION SUPPLIER NSC |
Shelley Chiropractic, P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 528 N State St, Shelley, ID 83274 Phone: 208-357-0333 Fax: 208-357-2299 |