Provider Demographics
NPI:1629456926
Name:K2RED LLC
Entity Type:Organization
Organization Name:K2RED LLC
Other - Org Name:MEDSYNC PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER/RPH
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:FUCHS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:208-364-7777
Mailing Address - Street 1:801 S VISTA AVE
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83705-2424
Mailing Address - Country:US
Mailing Address - Phone:208-364-7777
Mailing Address - Fax:208-364-7778
Practice Address - Street 1:801 S VISTA AVE
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705-2424
Practice Address - Country:US
Practice Address - Phone:208-364-7777
Practice Address - Fax:208-364-7778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-07
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy