Innovative Care Pharmacy Llc

LBN: Innovative Care Pharmacy
Innovative Care Pharmacy Llc is an health care organization with primary practice located at 9196 W Emerald St Ste 110, Boise ID 83704-0679. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Innovative Care Pharmacy can be contacted via phone (208) 323-1259, or through Moore, Sheila via phone (817) 552-7630.

Contact Information

Primary practice address
9196 W Emerald St Ste 110 Boise ID 83704-0679
Phone: (208) 323-1259
Fax: (208) 323-8934
Website:
Map and Directions
Authorized official contact:
Name: Moore, Sheila
Phone: (817) 552-7630

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X 2303CP Idaho

Profile Details

NPI number 1407966229
LBN Legal business name Innovative Care Pharmacy
DBA Doing business as Innovative Care Pharmacy Llc
Authorized official Moore, Sheila
Entity Organization
Organization subpart 1 No
Enumeration date Aug 30th, 2006
Last updated Sep 25th, 2009 - about 17 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 1407966229 NPPES
Idaho MEDICAID 806967700
Idaho Other 1307619

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