IDAHO STATE UNIVERSITY (NPI# 1730351081) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730351081 |
| Entity Type | Organization |
| Organization Name | IDAHO STATE UNIVERSITY |
| Other Organization Name | IDAHO STATE UNIVERSITY STUDENT HEALTH CENTER PHARMACY |
| Practice Address |
990 South 8th Pocatello ID 83209 |
| Mailing Address |
921 S 8th Ave Stop 8311 Pocatello ID 83209-0002 |
| Practice Telephone | 2082823407 |
| Mailing Telephone | 2082823407 |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2012-02-03 |
| Authorized Official Name | GINA DAVIS (PHARMACY MANAGER) |
| Authorized Official Telephone | 2082823407 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
349CP | ID | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 1307974 | 01 |
| Other Name | Type Code |
|---|---|
| Idaho State University Student Health Center Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811595929 | Idaho State University | Counselor | 1400 E Terry Dr Bldg 63, Pocatello, ID 83209-0001 | 2020-10-12 |
| 1801292115 | Idaho State University | Family Medicine | 921 S 8th Ave Stop 8173, Sports and Orthopaedic Center, Pocatello, ID 83209-8173 | 2014-11-13 |
| 1972720936 | Idaho State University | Dental Hygienist | 999 Martin Luther King Jr. Way, Pocatello, ID 83209-8048 | 2007-04-19 |
| 1356491187 | Idaho State University | Physical Therapist | 1400 E. Terry, Garrison Bldg. 63 #202, Pocatello, ID 83209-8045 | 2007-01-12 |
| 1578508081 | Idaho State University | Audiologist | 650 Memorial Drive, # 68, Pocatello, ID 83209-0001 | 2006-06-18 |
| 1235737347 | Idaho State University | Clinic/Center | 1311 E Central Dr, Meridian, ID 83642-7991 | 2020-10-12 |
| 1295105567 | Idaho State University | Clinical Medical Laboratory | 970 S 5th Ave, Stop 8288, Pocatello, ID 83209-0001 | 2015-09-30 |
| 1114285996 | Idaho State University | Local Education Agency (LEA) | 921 S 8th Ave, Mail Stop 8219, Pocatello, ID 83209-8219 | 2012-04-30 |
| 1912110164 | Idaho State University | Dentist | 2033 E Summersweet Dr, Boise, ID 83716-6695 | 2007-05-07 |
| 1851516256 | Idaho State University | Dentist | 465 Memorial Dr., Pocatello, ID 83209-8088 | 2007-04-13 |
| Street Address |
990 SOUTH 8TH |
| City | POCATELLO |
| State | ID |
| Zip Code | 83209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093097081 | Eydie Kendall | Physical Therapist | 1400 Terry Drive, Pocatello, ID 83209 | 2011-09-15 |
| 1548548589 | Corrie Elizabeth Holmes | Audiologist | 650 Memorial Drive Building 68, Pocatello, ID 83209 | 2011-07-25 |
| 1922204551 | Melody Ann Weaver | Nurse Practitioner | 921 S 8th Ave Stop 8101, Pocatello, ID 83209 | 2007-06-21 |
| 1710482500 | Ashley Letson | Specialist/Technologist | 921 S 8th Ave, Mcintosh Manor D9, Pocatello, ID 83209 | 2018-03-26 |
| 1407261407 | Stephen B Grandy | Dentist | 465 Memorial Drive, Pocatello, ID 83209-0000 | 2014-06-27 |
| 1811595929 | Idaho State University | Counselor | 1400 E Terry Dr Bldg 63, Pocatello, ID 83209-0001 | 2020-10-12 |
| 1174149389 | Santiago A Segura Barron | Specialist/Technologist | Holt Arena 550 Memorial Drive Building 50, Pocatello, ID 83209-0001 | 2020-06-23 |
| 1639658248 | Luis Rodriguez | Psychologist | 1400 Eas Terry Dr Bldg 63 Garrison Hall 5th Floor, Pocatello, ID 83209-0001 | 2018-08-14 |
| 1205384484 | Max Esposito | Physical Medicine & Rehabilitation | 1400 E Terry Dr, Pocatello, ID 83209-0001 | 2016-09-15 |
| 1306022041 | Kelly Elizabeth Thompson | Occupational Therapist | Department of Physical and Occupational Therapy, Mail Stop 8045, Pocatello, ID 83209-0001 | 2008-01-11 |
| Find all providers in zip 83209 | ||||
| Taxonomy Code | 3336C0002X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Clinic Pharmacy |
| A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. |
| 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 |
|---|---|---|---|---|
| 1164035689 | Allergy Butler, LLC | Pharmacy | 1611 12th Ave Rd Ste A, Nampa, ID 83686-6182 | 2020-08-25 |
| 1922312842 | Teton Valley Hospital Pharmacy | Pharmacy | 120 East Howard Ave., Driggs, ID 83422-5112 | 2010-08-03 |
| 1740717693 | Snake River Pharmacy | Pharmacy | 4750 Yellowstone Ave, Chubbuck, ID 83202-2336 | 2017-05-22 |
| 1184163511 | Bear Lake Community Health Center Pharmacy - 340b | Pharmacy | 152 S 4th St, Montpelier, ID 83254-1538 | 2017-02-17 |
| 1942615828 | Family Health Services Pharmacy | Pharmacy | 388 Martin Street, Family Health Services Pharmacy, Twin Falls, ID 83301-6856 | 2014-06-30 |
| 1669616272 | Community Health Clinics, Inc. | Pharmacy | 300 S 23rd St, Boise, ID 83702-9100 | 2009-04-27 |
| 1316156482 | Community Health Clinics, Inc. | Pharmacy | 802 Cleveland Blvd, Caldwell, ID 83605 | 2007-05-22 |
| 1770687188 | Community Health Clinics, Inc | Pharmacy | 223 16th Ave N, Nampa, ID 83687-4058 | 2006-09-08 |
Please comment or provide details below to improve the information on IDAHO STATE UNIVERSITY.
| 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.