| Organization Name: | PORTICO PHARMACY |
| NPI Number: | 1033382304 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERT EUGENE FLOTO (OWNER/MANAGER) |
| Mailing Address: | 3355 E Louise St Meridian |
| State: | ID US |
| Postal Code: | 83642 |
| Phone Number: | 2082884341 |
| Fax Number: | |
| NPI Enumeration Date: | 04/08/2008 |
| NPI Last Update Date: | 04/08/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |