Latah Health Pharmacy

LBN: Latah Community Health Pharmacy
Latah Health Pharmacy is an health care organization with primary practice located at 803 S Main St Ste 120 , Moscow ID 83843-3043. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Clinic Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Clinic Pharmacy is the primary health care specialty. Latah Community Health Pharmacy can be contacted via phone (208) 848-8312, or through Wilson, Aaron via phone (509) 444-8888.

Contact Information

Primary practice address
803 S Main St Ste 120 Moscow ID 83843-3043
Phone: (208) 848-8312
Fax: (208) 882-5587
Website:
Map and Directions
Authorized official contact:
Name: Wilson, Aaron
Phone: (509) 444-8888

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Clinic Pharmacy 3336C0002X 37042RP Idaho
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1750786356
LBN Legal business name Latah Community Health Pharmacy
DBA Doing business as Latah Health Pharmacy
Authorized official Wilson, Aaron
Entity Organization
Organization subpart 1 No
Enumeration date Oct 27th, 2014
Last updated Aug 21st, 2020 - about 6 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 1750786356 NPPES
Idaho MEDICAID 1750786356
Idaho Other 2148393
Idaho MEDICAID 2073987

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