Olson'S Modern Drug Co.
Organization Active NPI Community/Retail Pharmacy · Montpelier, ID
NPI 1083684906 · NPPES record last updated Dec 18, 2008
Key facts
- NPI
- 1083684906
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 476CP (ID)
- Legal business name
- OLSON'S MODERN DRUG CO.
- Practice address
- 762 Washington St
Montpelier, ID 83254-1422 - Phone
- (208) 847-0536
- Fax
- (208) 847-1578
- NPI assigned
- Jan 24, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Harold A Olson
- Title
- Owner-Pharmacist
- Phone
- (208) 847-0536
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 476CP | ID | Yes |
Addresses
Primary practice location
762 Washington St
Montpelier, ID 83254-1422
Mailing address
762 Washington St
Montpelier, ID 83254-1422
Phone (208) 847-0536
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002683500 | Medicaid | ID |
Other providers in Montpelier, ID
- Modern Compounding Pharmacy
- Alex C Moss
- Brad Joseph Nelson
- Noall E Wolff MD
- Harold A Olson
- Olympus Laboratories, LLC
- Nicholas Merrill Packer
- Joseph Edward Podany Jr.
- Jamie Prince Bartschi
- Reset P.a.
All providers in Montpelier, ID · Community/Retail Pharmacy in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 18, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.