BONNIE BRANNOCK-SIMONSON (NPI# 1497164263) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497164263 |
| Entity Type | Individual |
| Full Name | BONNIE BRANNOCK-SIMONSON |
| Credential | PHARM D |
| Practice Address |
5108 Cleveland Blvd Caldwell ID 83607-8002 |
| Practice Telephone | 2084550800 |
| Practice Fax Number | 2084555353 |
| Mailing Telephone | 2084550800 |
| Mailing Fax Number | 2084555353 |
| Enumeration Date | 2014-08-06 |
| Last Update Date | 2014-08-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | P6122 | ID | Pharmacy Service Providers |
| Street Address |
5108 CLEVELAND BLVD |
| City | CALDWELL |
| State | ID |
| Zip Code | 83607-8002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174540421 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 5108 Cleveland Blvd, Caldwell, ID 83607-8002 | 2006-07-16 |
| 1285035113 | John E Letter IIi | Pharmacist | 5108 Cleveland Blvd, Caldwell, ID 83607-8002 | 2014-09-10 |
| 1669889853 | Luke Michael Houston | Pharmacist | 5108 Cleveland Blvd, Caldwell, ID 83607-8002 | 2014-07-19 |
| 1245420926 | Kevin Cotter Odpa | Optometrist | 5108 Cleveland Blvd, Caldwell, ID 83607-8002 | 2007-07-27 |
| 1326138322 | Wal-mart Stores, Inc | Eyewear Supplier (Equipment, not the service) | 5108 Cleveland Blvd, Caldwell, ID 83607-8002 | 2006-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609106012 | Cordell Denton Nebeker | Dentist | 4111 Clocktower Ave., Caldwell, ID 83607 | 2010-01-07 |
| 1265677587 | Cory Shane Lindstrom | Chiropractor | 5216 E. Cleveland Blvd, Ste G, Caldwell, ID 83607 | 2008-12-16 |
| 1154533727 | Reality Based Services | Case Management | 24151 El Paso Rd, Caldwell, ID 83607 | 2007-05-04 |
| 1407998271 | Patrick L Waite | Dentist | 4101 Clock Tower Ave, Caldwell, ID 83607 | 2007-02-12 |
| 1104276377 | Jae's Transportaion LLC | Non-emergency Medical Transport (VAN) | 14310 Tara St, Caldwell, ID 83607-1431 | 2016-06-17 |
| 1417224460 | Rebecca Anne Tormey | Physical Therapist | 1202 Talon Ct, Caldwell, ID 83607-1579 | 2011-11-18 |
| 1174677603 | Vallivue School District #139 | Local Education Agency (LEA) | 5207 S Montana Ave, Caldwell, ID 83607-1583 | 2007-01-22 |
| 1679026447 | Kimberly Drewrey, Aprn, Np-c | Point of Service | 5210 Cleveland Blvd, Suite 140 #344, Caldwell, ID 83607-1796 | 2016-07-28 |
| 1619007903 | Mandy R Redmond | Specialist/Technologist | 1407 E Homedale Rd, Caldwell, ID 83607-1848 | 2007-03-06 |
| 1326263179 | Kira Ann Skroh | Specialist/Technologist | 1407 E Homedale Rd, Caldwell, ID 83607-1848 | 2007-04-16 |
| Find all providers in zip 83607 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669025359 | James Smith | Pharmacist | 2809 E Caldwell Blvd, Caldwell, ID 83605 | 2019-07-22 |
| 1215430483 | Amy E Rudolf | Pharmacist | 315 E Elm St Ste 150, Caldwell, ID 83605 | 2018-03-14 |
| 1952857161 | Mitchell Truong | Pharmacist | 622 E. Ustick Road, Caldwell, ID 83646 | 2016-08-28 |
| 1104239169 | Nichelle Daigle | Pharmacist | 622 E Ustick Rd, Caldwell, ID 83605 | 2014-06-08 |
| 1679910491 | Trisha M Beutler | Pharmacist | 11809 Shalako Rd, Caldwell, ID 83607-5095 | 2013-06-03 |
| 1477839405 | Chad Boughey | Pharmacist | 7017 Noah Dr Apt 201, Caldwell, ID 83607-5339 | 2011-10-21 |
| 1326335746 | Raymond Joffer | Pharmacist | 2500 Blaine St., Caldwell, ID 83605-4426 | 2011-07-06 |
| 1841519774 | Mital C Shah | Pharmacist | 356 Bloomfield Ave, Caldwell, NJ 07006-4905 | 2010-05-17 |
| 1215092044 | Rebecca Sue Dunlap | Pharmacist | 44523 Marietta Road, Caldwell, OH 43724 | 2006-12-22 |
| 1992800361 | Gregory Allen Paisley | Pharmacist | 109 West Street, Caldwell, OH 43724-1359 | 2006-09-13 |
| Find all providers in CALDWELL | ||||
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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.