Innovative Care Pharmacy Llc

LBN: Innovative Care Pharmacy
Innovative Care Pharmacy Llc is an health care organization with primary practice located at 9196 E Emerald St Ste 110, Boise ID 83704. The organization recently has only one registered license in Suppliers / Long Term Care Pharmacy, which is considered as the primary health care specialty. Innovative Care Pharmacy can be contacted via phone (208) 323-1259, or through Lanham, Brad via phone (817) 328-6421.

Contact Information

Primary practice address
9196 E Emerald St Ste 110 Boise ID 83704
Phone: (208) 323-1259
Fax: (208) 323-5666
Website:
Map and Directions
Authorized official contact:
Name: Lanham, Brad
Phone: (817) 328-6421

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Long Term Care Pharmacy 3336L0003X 2304LS Idaho

Profile Details

NPI number 1528055324
LBN Legal business name Innovative Care Pharmacy
DBA Doing business as Innovative Care Pharmacy Llc
Authorized official Lanham, Brad
Entity Organization
Organization subpart 1 No
Enumeration date Oct 5th, 2005
Last updated May 7th, 2013 - about 12 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 1528055324 NPPES
Other 2021877 PK
MEDICAID 80668600 PK

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