IDAHO STATE VETERAN HOME - LEWISTON (NPI# 1689687261) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689687261 |
| Entity Type | Organization |
| Organization Name | IDAHO STATE VETERAN HOME - LEWISTON |
| Practice Address |
821 21st Ave Lewiston ID 83501-6389 |
| Practice Telephone | 2087993422 |
| Practice Fax Number | 2087438833 |
| Mailing Telephone | 2087993422 |
| Mailing Fax Number | 2087438833 |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. K DOUGLAS CRAFTON (DIRECTOR OF PHARMACY) |
| Authorized Official Telephone | 2087993422 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
1042HP | ID | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | NCPDP NUMBER | 1307102 | 01 |
| DEA NUMBER | BI3974359 | 01 |
| Street Address |
821 21ST AVE |
| City | LEWISTON |
| State | ID |
| Zip Code | 83501-6389 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679562011 | Division of Veterans Services | Skilled Nursing Facility | 821 21st Ave, Lewiston, ID 83501-6389 | 2005-10-18 |
| 1508256694 | Monali Roy | Physical Therapist | 821 21st Ave, Lewiston, ID 83501-6389 | 2015-01-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679193759 | Jacqueline M Aldrich | Behavior Technician | 3407 12th Street C, 3407 12th Street C, Lewiston, ID 83501 | 2020-04-20 |
| 1295228054 | Provident Foundation - Wedgewood Terrace LLC | Alzheimer Center (Dementia Center) | 2114 Vineyard Avenue, Lewiston, ID 83501 | 2018-06-07 |
| 1164945325 | Xiaofei Liu | Massage Therapist | 234 Thain Rd, Lewiston, ID 83501 | 2017-07-19 |
| 1467909879 | Sharon Thulon | Registered Nurse | 1118 F Street, Lewiston, ID 83501 | 2016-09-01 |
| 1821459496 | Gem State Endoscopy | Clinic/Center | 3709 14th Street, Lewiston, ID 83501 | 2016-03-10 |
| 1508264995 | Gary L. Grogan | Psychologist | 633 Main Street, B#1, Lewiston, ID 83501 | 2014-12-17 |
| 1003189366 | John Joseph Johnson | Dentist | 3510 12th Street, Suite #600, Lewiston, ID 83501 | 2012-02-17 |
| 1306134077 | Rowena Kathryn Jackson | Counselor | 531 Bryden Avenue, Lewiston, ID 83501 | 2011-07-15 |
| 1912290388 | Staci Leanne Truby | Massage Therapist | 717 'd' Street, Lewiston, ID 83501 | 2011-05-18 |
| 1093040685 | Sharie Ann Uhlorn | Registered Nurse | 1837 Alder Court, Lewiston, ID 83501 | 2009-10-15 |
| Find all providers in zip 83501 | ||||
| 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 |
|---|---|---|---|---|
| 1689768145 | Chastains Incorporated | Pharmacy | 720 16th Ave, Suite 2, Lewiston, ID 83501-3768 | 2006-10-02 |
| 1619507761 | Hells Canyon Health and Wellness Pharmacy | Pharmacy | 523 Thain Rd, Lewiston, ID 83501-5530 | 2020-01-16 |
| 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 |
| 1750498044 | Marketime Drug of Moscow Inc | Pharmacy | 209 East Third St, Moscow, ID 83843 | 2006-08-24 |
| 1760494033 | Pharmerica Mountain LLC | Pharmacy | 2950 E Magic View Dr Ste 190, Meridian, ID 83642 | 2006-08-13 |
| 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.