<Unavail>

LBN: Mountain Care Pharmacy Idaho
<Unavail> is an health care organization with primary practice located at 1753 W Broadway St , Idaho Falls ID 83402-3045. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Long Term Care Pharmacy is the primary health care specialty. Mountain Care Pharmacy Idaho can be contacted via phone (208) 932-1260, or through Stong, Jared via phone (801) 747-7191.

Contact Information

Primary practice address
1753 W Broadway St Idaho Falls ID 83402-3045
Phone: (208) 932-1260
Fax: (208) 523-2330
Website:
Map and Directions
Authorized official contact:
Name: Stong, Jared
Phone: (801) 747-7191

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X
Suppliers / Long Term Care Pharmacy 3336L0003X 18014LS Idaho

Profile Details

NPI number 1588937395
LBN Legal business name Mountain Care Pharmacy Idaho
DBA Doing business as <Unavail>
Authorized official Stong, Jared
Entity Organization
Organization subpart 1 No
Enumeration date Feb 10th, 2012
Last updated Feb 10th, 2012 - about 14 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 1588937395 NPPES
Other 1308661 NCPDP PROVIDER IDENTIFICATION NUMBER

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