EASTGATE DRUG (NPI# 1609800937) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609800937 |
| Entity Type | Organization |
| Organization Name | EASTGATE DRUG |
| Other Organization Name | EASTGATE DRUG STORE |
| Practice Address |
3250 E 17th St Ammon ID 83406-6758 |
| Practice Telephone | 2085221243 |
| Practice Fax Number | 2085233780 |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | COREY SMITH (PRESIDENT) |
| Authorized Official Telephone | 2085221243 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 333600000X | Pharmacy | 1010CP | ID | Suppliers |
| X | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 1301073 | 01 |
| Other Name | Type Code |
|---|---|
| EASTGATE DRUG STORE | Doing Business As Name - Organization |
| Street Address |
3250 E 17TH ST |
| City | AMMON |
| State | ID |
| Zip Code | 83406-6758 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740265420 | Pharmease LLC | Pharmacy | 3250 E 17th St, Ammon, ID 83406-6758 | 2005-12-14 |
| 1073079281 | Spencer Louis Dietz | Pharmacist | 3250 E 17th St, Ammon, ID 83406-6758 | 2019-02-12 |
| 1851872436 | Amanda Kay Whitmill | Pharmacist | 3250 E 17th St, Ammon, ID 83406-6758 | 2018-08-22 |
| 1952888372 | Lisa J Cowley | Pharmacist | 3250 E 17th St, Ammon, ID 83406-6758 | 2018-07-27 |
| 1043760648 | Bruce Webb | Pharmacist | 3250 E 17th St, Ammon, ID 83406-6758 | 2016-10-06 |
| 1912308438 | Derik C Christensen | Pharmacist | 3250 E 17th St, Ammon, ID 83406-6758 | 2014-09-16 |
| 1205170420 | Karleen L Lynes | Pharmacist | 3250 E 17th St, Ammon, ID 83406-6758 | 2012-11-15 |
| 1548423338 | Pharmease LLC | Durable Medical Equipment & Medical Supplies | 3250 E 17th St, Ammon, ID 83406-6758 | 2008-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598383929 | Cristina Leon, Do Pa | Pediatrics | Idaho Falls Pediatrics, 3067 Eagle Dr, Ammon, ID 83406 | 2020-07-13 |
| 1144783499 | Mountain States Diabetes Relief, LLC | Internal Medicine | 4573 E Majestic, Idaho Falls, ID 83406 | 2019-04-12 |
| 1447718853 | Root Cause Integrative Medicine LLC | Family Medicine | 1547 S Midway Ave, Suite B, Ammon, ID 83406 | 2019-03-05 |
| 1225379183 | Sterling Hospital LLC | General Acute Care Hospital | 5412 S. Rock House Cir, Idaho Falls, ID 83406 | 2013-03-01 |
| 1710236823 | Flower D. Aston | Dietitian, Registered | 300 Bridger Drive, Ammon, ID 83406 | 2012-09-05 |
| 1558658468 | Nathan Myers | Pharmacist | 1901 South 2500 East, Idaho Falls, ID 83406 | 2011-06-30 |
| 1760719934 | Snf Ammon Operating Company LLC. | Skilled Nursing Facility | 3909 South 25th East, Ammon, ID 83406 | 2009-11-10 |
| 1316192370 | A Childs Smile | Dentist | 3299 E. 17th Street, Ammon, ID 83406 | 2008-11-18 |
| 1992968804 | Brandon D Gordon | Dentist | 7186 Sage View Cr, Idaho Falls, ID 83406 | 2008-07-10 |
| 1891996526 | Help, Inc. | Community/Behavioral Health | 1465 Hoopes Ave, Idaho Falls, ID 83406 | 2007-05-30 |
| Find all providers in zip 83406 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| 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: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386202026 | Genoa Healthcare, LLC | Pharmacy | 2705 E 17th St Ste S5, Ammon, ID 83406-6601 | 2019-05-29 |
| 1740265420 | Pharmease LLC | Pharmacy | 3250 E 17th St, Ammon, ID 83406-6758 | 2005-12-14 |
| 1851854095 | Broulim Supermarkets, LLC | Pharmacy | 3160 E 17th St Ste 164, Ammon, ID 83406-6784 | 2019-04-12 |
| 1689605735 | K Mart Corp | Pharmacy | 3101 E 17th St, Ammon, ID 83406-6717 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043878598 | Legranderx Pharmacy LLC | Pharmacy | 343 E 4th N Ste 126, Rexburg, ID 83440-6004 | 2019-05-30 |
| 1669935813 | Broulim Supermarkets, LLC | Pharmacy | 301 Aspen Sq, Saint Anthony, ID 83445-1662 | 2019-04-12 |
| 1851894380 | Medicine Man North Pharmacy Inc | Pharmacy | 30585 N Roberts Rd, Hayden, ID 83835 | 2018-03-11 |
| 1881194090 | Doc's Pharmacy2 LLC | Pharmacy | 16438 N Highway 41, Rathdrum, ID 83858-6888 | 2018-02-14 |
| 1508365958 | P. Roman Burk Dpm PC | Pharmacy | 2667 E. Gala Court Suite 125, Meridian, ID 83642 | 2018-02-12 |
| 1053860767 | Gooding Pharmacy Inc | Pharmacy | 120 South Apple, Suite A, Shoshone, ID 83352 | 2016-09-23 |
| 1649644584 | Yokes Foods Inc | Pharmacy | 1501 E Seltice Way, Post Falls, ID 83854-7531 | 2015-11-16 |
| 1629452776 | Shopko Stores Operating Co., LLC | Pharmacy | 429 Michigan Ave, Orofino, ID 83544-0000 | 2015-07-17 |
| 1164811402 | Ashton Memorial, Inc | Pharmacy | 23 S. 8th St., Ashton, ID 83420 | 2015-01-09 |
| 1053742577 | Gemstate Pharmacy Group Inc | Pharmacy | 800 S Industry Way Ste 330, Meridian, ID 83642-3598 | 2013-12-09 |
| 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.