MOUNTAIN CARE PHARMACY IDAHO (NPI# 1588937395) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588937395 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN CARE PHARMACY IDAHO |
| Other Organization Name | MOUNTAIN CARE PHARMACY |
| Practice Address |
1753 W Broadway St Idaho Falls ID 83402-3045 |
| Mailing Address |
1030 Bellwood Ln Murray UT 84123-4494 |
| Practice Telephone | 2089321260 |
| Practice Fax Number | 2085232330 |
| Mailing Telephone | 8017477191 |
| Mailing Fax Number | 8017477192 |
| Enumeration Date | 2012-02-10 |
| Last Update Date | 2012-02-10 |
| Authorized Official Name | JARED STONG (OWNER) |
| Authorized Official Telephone | 8017477191 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
18014LS | ID | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 1308661 | 01 |
| Other Name | Type Code |
|---|---|
| Mountain Care Pharmacy | Doing Business As Name - Organization |
| Street Address |
1753 W BROADWAY ST |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83402-3045 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013907567 | Kalob J. Parsons | Audiologist | 1753 W Broadway St, Idaho Falls, ID 83402-3045 | 2005-10-26 |
| 1861055436 | Savannah Shayne Collins | Audiologist | 1753 W Broadway St, Idaho Falls, ID 83402-3045 | 2019-04-18 |
| 1053719047 | Better Hearing and Audiology LLC | Hearing Aid Equipment | 1753 W Broadway St, Idaho Falls, ID 83402-3045 | 2014-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648015 | Abigail Oakley | Counselor | Tueller Counseling Services, 2275 W Broadway Suite G, Idaho Falls, ID 83402 | 2020-10-30 |
| 1265041479 | Fresenius Medical Care Snake River | Clinic/Center | 3195 South Fork Blvd, Idaho Falls, ID 83402 | 2020-07-24 |
| 1295352391 | Fresenius Medical Care Idaho Falls, LLC | Clinic/Center | 3193 South Fork Blvd, Idaho Falls, ID 83402 | 2020-07-06 |
| 1952923765 | Sterling Provider Group | Clinic/Center | 7017 Daisy Lane, Idaho Falls, ID 83402 | 2020-05-14 |
| 1528604188 | Leslie Hendrian | Massage Therapist | 86 N Kaylee Circle, Idaho Falls, ID 83402 | 2019-11-19 |
| 1154966760 | Christine Nicole Cardona | Counselor | 855 N. Captital Ave Ste 1, Idaho Falls, ID 83402 | 2019-11-07 |
| 1750847786 | Brandi S Warnke | Social Worker | 254 E Street, Suite B, Idaho Falls, ID 83402 | 2019-02-14 |
| 1013402809 | Kailey Lynn Moore | Pharmacist | 376 West 18th Street, Idaho Falls, ID 83402 | 2018-06-25 |
| 1407368616 | Jessica Owsley | Social Worker | 2275 W Broadway Ste G, Idaho Falls, ID 83402 | 2017-10-27 |
| 1427419886 | Becky Allen | Developmental Therapist | 150 Shoupe Ave, Idaho Falls, ID 83402 | 2016-03-14 |
| Find all providers in zip 83402 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Long Term Care Pharmacy |
| A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| 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 |
|---|---|---|---|---|
| 1144842600 | Deblaquiere Enterprises, Inc. | Pharmacy | 1319 Hwy 2, Suite A, Sandpoint, ID 83864 | 2020-05-07 |
| 1225668957 | Chemist Prime LLC | Pharmacy | 222 N Maple Grove Rd, Boise, ID 83704-8239 | 2020-01-22 |
| 1609430479 | Continued Care Ltc Pharmacy Idaho LLC | Pharmacy | 8601 W Emerald St Ste 176, Boise, ID 83704-8297 | 2019-04-27 |
| 1609365345 | Cd Pharmacy LLC | Pharmacy | 2370 S Titanium Pl, Meridian, ID 83642-6867 | 2018-05-08 |
| 1952645285 | Readings Community Pharmacy Inc | Pharmacy | 133 West A, Jerome, ID 83338 | 2012-11-27 |
| 1861616740 | Keymed, Inc | Pharmacy | 426 W Lewis St, Pocatello, ID 83204-3218 | 2007-04-12 |
| 1750442315 | State of Idaho | Pharmacy | 700 East Alice Street, Blackfoot, ID 83221 | 2006-12-13 |
| 1316029184 | Tnt Apothecary LLC | Pharmacy | 280 S Idaho St, Wendell, ID 83355-5200 | 2006-10-20 |
| 1689768145 | Chastains Incorporated | Pharmacy | 720 16th Ave, Suite 2, Lewiston, ID 83501-3768 | 2006-10-02 |
| 1750498044 | Marketime Drug of Moscow Inc | Pharmacy | 209 East Third St, Moscow, ID 83843 | 2006-08-24 |
| Find all providers with the same taxonomy | ||||
| City | IDAHO FALLS |
| Zip Code | 83402 |
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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.