Provider Demographics
NPI:1265824312
Name:DRUGSHIELD INC
Entity Type:Organization
Organization Name:DRUGSHIELD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-353-0291
Mailing Address - Street 1:3085 N COLE RD
Mailing Address - Street 2:STE 108
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-5968
Mailing Address - Country:US
Mailing Address - Phone:208-353-0291
Mailing Address - Fax:
Practice Address - Street 1:3085 N COLE RD
Practice Address - Street 2:STE 108
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-5968
Practice Address - Country:US
Practice Address - Phone:208-353-0291
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-26
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty