LADD FAMILY PHARMACY LLC (NPI# 1134391121) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134391121 |
| Entity Type | Organization |
| Organization Name | LADD FAMILY PHARMACY LLC |
| Other Organization Name | LADD FAMILY PHARMACY |
| Practice Address |
1109 S Broadway Ave Boise ID 83706-3626 |
| Practice Telephone | 2089470877 |
| Practice Fax Number | 2089470874 |
| Mailing Telephone | 2089470877 |
| Mailing Fax Number | 2089470874 |
| Enumeration Date | 2008-03-30 |
| Last Update Date | 2017-08-01 |
| Authorized Official Name | JEREMY LUNDEVALL (COO) |
| Authorized Official Telephone | 2089470877 |
| Authorized Official Credential | CPHT |
| 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 | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
38076RP | ID | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2022000 | 01 | |
| ID | M8081177 | 05 | |
| ID | M8081035 | 05 |
| Other Name | Type Code |
|---|---|
| LADD FAMILY PHARMACY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679082945 | Ladd Family Pharmacy LLC | Pharmacy | 2000 American Legion Blvd, Mountain Home, ID 83647-3138 | 2017-09-29 |
| Street Address |
1109 S BROADWAY AVE |
| City | BOISE |
| State | ID |
| Zip Code | 83706-3626 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861939969 | William Devereux | Pharmacist | 1109 S Broadway Ave, Boise, ID 83706-3626 | 2017-01-26 |
| 1023492303 | Andrew Harmon | Pharmacist | 1109 S Broadway Ave, Boise, ID 83706-3626 | 2015-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164993010 | Brette Marie Stephenson | Counselor | 1529 Belmont St., Boise, ID 83706 | 2018-12-17 |
| 1295249241 | Boise of Cascadia, LLC | Skilled Nursing Facility | 6000 W. Denton St., Boise, ID 83706 | 2017-11-29 |
| 1174035638 | Zacharia Njoroge | Physician Assistant | 1055 N Curtis Rd 6th Floor, Boise, ID 83706 | 2017-10-24 |
| 1740708965 | Total Renal Care Inc | Clinic/Center | 1070 N Curtis Rd Ste 125, Boise, ID 83706 | 2017-09-08 |
| 1023532173 | Amber Frisch | Massage Therapist | 2509 S Gekeler Lane, Boise, ID 83706 | 2017-07-31 |
| 1952768145 | Katie Garcin | Specialist | 1407 E Boston Dr, Boise, ID 83706 | 2016-01-20 |
| 1770950677 | Kathryn Bender | Counselor | 1205 N Garden St, Boise, ID 83706 | 2015-08-26 |
| 1457751802 | Sabrina Shumar | Physician Assistant | 901 N Curtis Rd Ste 501, Boise, ID 83706 | 2014-09-03 |
| 1831525070 | Katie Joy Wilson | Social Worker | 333 W. Rossi St. #300, Boise, ID 83706 | 2013-09-19 |
| 1609208610 | Christine Lea Eden | Surgery | 1075 N Curtis Rd Ste 101, Boise, ID 83706 | 2013-07-31 |
| Find all providers in zip 83706 | ||||
| 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 |
|---|---|---|---|---|
| 1477870103 | Walgreen Co | Pharmacy | 6195 S Five Mile Rd, Boise, ID 83709-6202 | 2010-04-20 |
| 1417188632 | Hayes Inspirations | Pharmacy | 286 N Maple Grove Rd, Boise, ID 83704-8239 | 2009-08-05 |
| 1578615530 | Drugs Inc | Pharmacy | 1221 Broadway Ave, Boise, ID 83706-3701 | 2007-01-18 |
| 1407966229 | Innovative Care Pharmacy | Pharmacy | 9196 W Emerald St, Ste 110, Boise, ID 83704-0679 | 2006-08-30 |
| 1134134257 | Walgreen Co | Pharmacy | 6725 N Glenwood St, Boise, ID 83714-1926 | 2006-07-29 |
| 1750840419 | Jacob Fuchs | Pharmacy | 801 S Vista Ave, Boise, ID 83705-2424 | 2019-03-12 |
| 1619441383 | Safeway Inc | Pharmacy | 250 E Parkcenter Blvd, Boise, ID 83706-3940 | 2019-01-16 |
| 1649770876 | Albertsons Companies Inc | Pharmacy | 250 E Parkcenter Blvd, Boise, ID 83706-3940 | 2018-02-14 |
| 1316462393 | Albertsons Companies LLC | Pharmacy | 250 E Parkcenter Blvd, Boise, ID 83706-3940 | 2017-08-10 |
| 1861917858 | Medcart Specialty Care LLC | Pharmacy | 250 E Parkcenter Blvd, Boise, ID 83706-3940 | 2017-08-10 |
| Find all providers in BOISE | ||||
Please comment or provide details below to improve the information on LADD FAMILY PHARMACY LLC.
| 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.