BONNER PROFESSIONAL COMPOUNDING (NPI# 1154532794) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154532794 |
| Entity Type | Organization |
| Organization Name | BONNER PROFESSIONAL COMPOUNDING |
| Practice Address |
520 N 3rd Ave Sandpoint ID 83864-1507 |
| Practice Telephone | 2082651093 |
| Practice Fax Number | 2082651031 |
| Mailing Telephone | 2082651093 |
| Mailing Fax Number | 2082651031 |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. MARY F. SNIDER (PHARMACIST IN CHARGE) |
| Authorized Official Telephone | 2082651093 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
1402CP | ID | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | NCPDS # | 1306718 | 01 |
| ID | STATE LICENSE # | 1402CP | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093850877 | Bonner Professional Compounding | Pharmacist | 520 N 3rd Ave, Sandpoint, ID 83864-1507 | 2007-02-20 |
| Street Address |
520 N 3RD AVE |
| City | SANDPOINT |
| State | ID |
| Zip Code | 83864-1507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144287756 | Bonner General Hospital, Inc. | General Acute Care Hospital | 520 N 3rd Ave, Sandpoint, ID 83864-1507 | 2006-04-27 |
| 1710515176 | Andrew John Coyle | Dietitian, Registered | 520 N 3rd Ave, Sandpoint, ID 83864-1507 | 2020-03-31 |
| 1285262808 | Mauria Prince | Pharmacist | 520 N 3rd Ave, Sandpoint, ID 83864-1507 | 2020-03-30 |
| 1851927073 | Sara Couch | Pharmacist | 520 N 3rd Ave, Sandpoint, ID 83864-1507 | 2020-03-19 |
| 1295361418 | Mary F Snider | Pharmacist | 520 N 3rd Ave, Sandpoint, ID 83864-1507 | 2020-03-19 |
| 1992362818 | Amanda Black | Occupational Therapist | 520 N 3rd Ave, Sandpoint, ID 83864-1507 | 2019-05-27 |
| 1538522511 | Apollo Med Anesthesia Pllc | Nurse Anesthetist, Certified Registered | 520 N 3rd Ave, Sandpoint, ID 83864-1507 | 2016-03-29 |
| 1922436062 | Siesta Anesthesia Services, Pllc | Anesthesiology | 520 N 3rd Ave, Sandpoint, ID 83864-1507 | 2013-10-29 |
| 1265703789 | Adam M Kerr | Nurse Anesthetist, Certified Registered | 520 N 3rd Ave, Sandpoint, ID 83864-1507 | 2012-01-13 |
| 1669781639 | Charles Howlett | Physical Therapist | 520 N 3rd Ave, Sandpoint, ID 83864-1507 | 2010-09-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144842600 | Deblaquiere Enterprises, Inc. | Pharmacy | 1319 Hwy 2, Suite A, Sandpoint, ID 83864 | 2020-05-07 |
| 1245867670 | Kimberly Sue Batchelder | Massage Therapist | Sandpoint Medical Massage & Bodyworks, LLC, 515 Pine Street Ste G., Sandpoint, ID 83864 | 2020-03-25 |
| 1699309963 | Ckam Rejuvenation Center LLC | Massage Therapist | 1315 Us-2, #5, Sandpoint, ID 83864 | 2020-02-26 |
| 1427602986 | Alpine Hand Therapy Inc | Physical Medicine & Rehabilitation | 1205 Hwy 2, Suite 102, Sandpoint, ID 83864 | 2019-08-01 |
| 1295388536 | Momentum Medical Massage and Personal Training, LLC | Massage Therapist | 1013 W Lake St, Sandpoint, ID 83864 | 2019-07-16 |
| 1629508932 | Karen Elizabeth Vollmer-poseley | Counselor | 506 N. 4th Ave, Sandpoint, ID 83864 | 2017-06-19 |
| 1760912042 | Gregory Jon Anthony Prins | Dentist | 1305 Highway 2 West, Sandpoint, ID 83864 | 2017-06-19 |
| 1730547084 | Charity Catlin | Midwife | 204 N 4th Ave #2355, Sandpoint, ID 83864 | 2016-02-02 |
| 1497148860 | Loftus Family Dental - Sandpoint Pllc | Dentist | 1310 Ponderosa Drive, Suite A, Sandpoint, ID 83864 | 2015-03-10 |
| 1215365523 | Tamarack Treatment and Counseling Center, Pllc | Counselor | 101 N. Boyer Ave, Sandpoint, ID 83864 | 2013-10-23 |
| Find all providers in zip 83864 | ||||
| Taxonomy Code | 3336C0004X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Compounding Pharmacy |
| A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner’s Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice. |
| Notes: Sources: NABP Model Practice Act, Appendix C - Good Compounding Practice, USP <795> and <797>, and Pharmacy Compounding Accreditation Board [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073133328 | Prescription Pad LLC | Pharmacy | 885 S Vanguard Way, Meridian, ID 83642 | 2020-04-16 |
| 1790321321 | Sawtooth Compounding Pharmacy, LLC | Pharmacy | 90 S Cole Rd, Boise, ID 83709-0930 | 2019-11-19 |
| 1518401512 | Ram Pharma, Inc. | Pharmacy | 1125 Hollipark Dr, Idaho Falls, ID 83401-5806 | 2016-12-09 |
| 1629456926 | K2red LLC | Pharmacy | 801 S Vista Ave, Boise, ID 83705-2424 | 2015-05-07 |
| 1578826178 | Medicine Man Bonners Ferry Pharmacy LLC | Pharmacy | 6452 Main St, Bonners Ferry, ID 83805-8520 | 2012-06-19 |
| 1891017208 | Hb Ventures Rx LLC | Pharmacy | 3355 E Louise Dr, Meridian, ID 83642-5047 | 2010-02-26 |
| 1457682114 | Custom Rx | Pharmacy | 173 W 4th St, Kuna, ID 83634-2046 | 2010-01-20 |
| 1972633915 | Maag Prescription Center LLC | Pharmacy | 333 W. Center St., Pocatello, ID 83204 | 2007-03-07 |
| 1780729988 | Customedica Pharmacy, Inc | Pharmacy | 149 W State St, Suite 101, Eagle, ID 83616-4959 | 2007-02-21 |
| 1598868770 | Well Life Pharmacy Incorporated | Pharmacy | 565 N Vest St, Post Falls, ID 83854-7066 | 2006-09-06 |
| Find all providers with the same taxonomy | ||||
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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.