MEDICINE MAN WEST PHARMACY LLC (NPI# 1124193487) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124193487 |
| Entity Type | Organization |
| Organization Name | MEDICINE MAN WEST PHARMACY LLC |
| Other Organization Name | MEDICINE MAN WEST PHARMACY |
| Practice Address |
802 E Medical Ct Post Falls ID 83854-7298 |
| Practice Telephone | 2087733566 |
| Practice Fax Number | 2087778239 |
| Mailing Telephone | 2087733566 |
| Mailing Fax Number | 2087778239 |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2013-09-16 |
| Authorized Official Name | DONALD SMITH (OWNER) |
| Authorized Official Telephone | 2087733566 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
719CP | ID | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 1304411 | 01 | |
| ID | MEDICARE PART B | 20002785 | 01 |
| ID | 002599400 | 05 |
| Other Name | Type Code |
|---|---|
| MEDICINE MAN WEST PHARMACY | Doing Business As Name - Organization |
| Street Address |
802 E MEDICAL CT |
| City | POST FALLS |
| State | ID |
| Zip Code | 83854-7298 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104488428 | Chaney M Boyle | Pharmacist | 802 E Medical Ct, Post Falls, ID 83854-7298 | 2019-07-08 |
| 1578013728 | Shea Sevy | Pharmacist | 802 E Medical Ct, Post Falls, ID 83854-7298 | 2016-10-12 |
| 1861744872 | Justin Jon Sanders | Pharmacist | 802 E Medical Ct, Post Falls, ID 83854-7298 | 2012-10-15 |
| 1821315821 | Katherine J.d. Smith | Pharmacist | 802 E Medical Ct, Post Falls, ID 83854-7298 | 2010-04-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487264032 | Esteem Counseling, LLC | Counselor | 1404 North Marcasite Court, Post Falls, ID 83854 | 2020-08-07 |
| 1497376685 | Teresa Marie Ragan | Registered Nurse | 1551 E Mullan Ave Bldg A, Ste 200b, Post Falls, ID 83854 | 2020-04-29 |
| 1245792910 | Samantha Patricia Bourassa | Specialist/Technologist | 2832 E Poleline Ave, Post Falls, ID 83854 | 2019-04-02 |
| 1003392598 | Joshua Welz | Psychologist | 3211 N Guinness Ln Apt 201, Post Falls, ID 83854 | 2018-07-17 |
| 1639608094 | Anthony Leodis Walls Jr. | Specialist/Technologist | 8732 N Meyer Rd, Post Falls, ID 83854 | 2017-06-08 |
| 1831635911 | Glenda Felts | Social Worker | 8561 N Cloverleaf Rd, # 22, Hauser, ID 83854 | 2017-01-12 |
| 1144763467 | Rachel M. Pope | Behavioral Analyst | 204 E 1st Ave Apt 4, Post Falls, ID 83854 | 2016-11-18 |
| 1871960393 | Randy Robinson | Massage Therapist | 2525 E Seltice Way Ste C, Post Falls, ID 83854 | 2015-09-01 |
| 1194112375 | James Bailey | Family Medicine | 185 W 4th Ave Ste B, Post Falls, ID 83854 | 2015-04-24 |
| 1033534953 | Lauren Tandy | Speech-Language Pathologist | 398 S. Corbin Rd., Post Falls, ID 83854 | 2014-02-28 |
| Find all providers in zip 83854 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295336709 | Family Health Services Pharmacy | Pharmacy | 218 W. Nez Perce, Jerome, ID 83338 | 2020-11-03 |
| 1841806494 | Deblaquiere Enterprises, Inc. | Pharmacy | 86 Tank Rd, Oldtown, ID 83822-5126 | 2020-09-18 |
| 1043838584 | Costco Wholesale Corporation | Pharmacy | 3403 W Chinden Blvd, Meridian, ID 83646-7151 | 2020-07-10 |
| 1265054324 | Costco Wholesale Corporation | Pharmacy | 2495 E Lincoln Rd, Idaho Falls, ID 83401-2203 | 2020-05-12 |
| 1851923544 | Rocky Mountain Pharmacy, LLC | Pharmacy | 3910 Washington Pkwy Ste A, Idaho Falls, ID 83404-7884 | 2020-02-10 |
| 1013559269 | Timberline Pharmacy | Pharmacy | 4574 N Ten Mile Rd Ste 110, Meridian, ID 83646-6930 | 2019-10-09 |
| 1508420373 | K2red LLC | Pharmacy | 447 N Idaho St, Wendell, ID 83355 | 2019-04-27 |
| 1679039135 | Hollis Family Pharmacy LLC | Pharmacy | 845 S Substation Rd, Emmett, ID 83617 | 2019-02-20 |
| 1598229809 | Clearwater Canyon Pharmacy, LLC | Pharmacy | 13020 Us-12, Orofino, ID 83544 | 2019-01-31 |
| 1861999377 | Bi-mart Corporation | Pharmacy | 11347 W State Street, Star, ID 83669 | 2018-04-11 |
| Find all providers with the same taxonomy | ||||
| City | POST FALLS |
| Zip Code | 83854 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.