State Of Idaho-Dba Idaho State School & Hospital Pharmacy

LBN: State Of Idaho-Dba Idaho State School & Hospital Pharmacy
State Of Idaho-Dba Idaho State School & Hospital Pharmacy is an health care organization with primary practice located at 1660 11Th Ave N , Nampa ID 83687-5000. The organization recently has only one registered license in Suppliers / Institutional Pharmacy, which is considered as the primary health care specialty. State Of Idaho-Dba Idaho State School & Hospital Pharmacy can be contacted via phone (208) 442-2812, or through Broetje, Susan via phone (208) 442-2812.

Contact Information

Primary practice address
1660 11Th Ave N Nampa ID 83687-5000
Phone: (208) 442-2812
Fax: (208) 467-3406
Website:
Map and Directions
Authorized official contact:
Name: Broetje, Susan
Phone: (208) 442-2812

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Institutional Pharmacy 3336I0012X 539-HP Idaho

Profile Details

NPI number 1265559314
LBN Legal business name State Of Idaho-Dba Idaho State School & Hospital Pharmacy
DBA Doing business as
Authorized official Broetje, Susan
Entity Organization
Organization subpart 1 No
Enumeration date Mar 23rd, 2007
Last updated Aug 22nd, 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 1265559314 NPPES
Idaho MEDICAID 0028335600

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