White Cross Pharmacy - Oldtown

LBN: Deblaquiere Enterprises, Inc.
White Cross Pharmacy - Oldtown is an health care organization with primary practice located at 86 Tank Rd , Oldtown ID 83822-5126. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Deblaquiere Enterprises, Inc. can be contacted via phone (208) 457-7160, or through De Blaquiere, Richard Allan via phone (208) 610-0752.

Contact Information

Primary practice address
86 Tank Rd Oldtown ID 83822-5126
Phone: (208) 457-7160
Fax: (208) 369-4553
Website:
Map and Directions
Authorized official contact:
Name: De Blaquiere, Richard Allan PHARMD
Phone: (208) 610-0752

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1841806494
LBN Legal business name Deblaquiere Enterprises, Inc.
DBA Doing business as White Cross Pharmacy - Oldtown
Authorized official De Blaquiere, Richard Allan PHARMD
Entity Organization
Organization subpart 1 No
Enumeration date Sep 18th, 2020
Last updated Dec 3rd, 2021 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841806494 NPPES
Idaho MEDICAID 1841806494

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