| Sandpoint Super Drug Clinical Services | |
|
604 N Fifth Ave Sandpoint ID 83864-1520 | |
| (208) 263-1408 | |
| Not Available |
| Full Name | Sandpoint Super Drug Clinical Services |
|---|---|
| Speciality | Family Medicine |
| Location | 604 N Fifth Ave, Sandpoint, Idaho |
| Authorized Official Name and Position | Scott Porter (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 2082631408 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sandpoint Super Drug Clinical Services 604 N Fifth Ave Sandpoint ID 83864-1520 Ph: (208) 263-1408 | Sandpoint Super Drug Clinical Services 604 N Fifth Ave Sandpoint ID 83864-1520 Ph: (208) 263-1408 |
| NPI Number | 1104584739 |
|---|---|
| Provider Enumeration Date | 12/01/2021 |
| Last Update Date | 03/24/2022 |
| Certification Date | 03/24/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104584739 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (NU) | Primary |
| 3336C0002X | Pharmacy - Clinic Pharmacy | (NU) | Secondary |
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