Isu Bengal Pharmacy Challis

LBN: Idaho State University
Isu Bengal Pharmacy Challis is an health care organization with primary practice located at 609 Clinic Rd , Challis ID 83226-0070. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Idaho State University can be contacted via phone (208) 879-4600, or through Brower, Brady Victor via phone (208) 282-3407.

Contact Information

Primary practice address
609 Clinic Rd Challis ID 83226-0070
Phone: (208) 879-4600
Fax: (208) 879-5379
Website:
Map and Directions
Authorized official contact:
Name: Brower, Brady Victor PHARMD
Phone: (208) 282-3407

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1376602680
LBN Legal business name Idaho State University
DBA Doing business as Isu Bengal Pharmacy Challis
Authorized official Brower, Brady Victor PHARMD
Entity Organization
Organization subpart 1 No
Enumeration date Dec 6th, 2006
Last updated Feb 23rd, 2022 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376602680 NPPES
Idaho MEDICAID 1376602680

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