Ladd Family Pharmacy

LBN: Ladd Family Pharmacy Llc
Ladd Family Pharmacy is an health care organization with primary practice located at 1109 S Broadway Ave , Boise ID 83706-3626. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Ladd Family Pharmacy Llc can be contacted via phone (208) 947-0877, or through Lundevall, Jeremy via phone (208) 947-0877.

Contact Information

Primary practice address
1109 S Broadway Ave Boise ID 83706-3626
Phone: (208) 947-0877
Fax: (208) 947-0874
Website:
Map and Directions
Authorized official contact:
Name: Lundevall, Jeremy CPHT
Phone: (208) 947-0877

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Community/Retail Pharmacy 3336C0003X 38076RP Idaho
Suppliers / Compounding Pharmacy 3336C0004X

Profile Details

NPI number 1134391121
LBN Legal business name Ladd Family Pharmacy Llc
DBA Doing business as Ladd Family Pharmacy
Authorized official Lundevall, Jeremy CPHT
Entity Organization
Organization subpart 1 No
Enumeration date Mar 30th, 2008
Last updated Aug 1st, 2017 - about 9 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 1134391121 NPPES
Other 2022000 PK
MEDICAID M8081177 PK
MEDICAID M8081035 PK

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