Provider Demographics
NPI:1356430953
Name:ROE AND ROE, INC.
Entity type:Organization
Organization Name:ROE AND ROE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:EDITH
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROE
Authorized Official - Suffix:
Authorized Official - Credentials:PT, RN
Authorized Official - Phone:208-337-3898
Mailing Address - Street 1:5 N. MAIN ST.
Mailing Address - Street 2:PO BOX 37
Mailing Address - City:HOMEDALE
Mailing Address - State:ID
Mailing Address - Zip Code:83628
Mailing Address - Country:US
Mailing Address - Phone:208-337-3898
Mailing Address - Fax:208-337-4652
Practice Address - Street 1:5 N. MAIN ST.
Practice Address - Street 2:
Practice Address - City:HOMEDALE
Practice Address - State:ID
Practice Address - Zip Code:83628
Practice Address - Country:US
Practice Address - Phone:208-337-3898
Practice Address - Fax:208-337-4652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID1418CP3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy