BYU ID STUDENT HLTH CNTR PCHY (NPI# 1992726962) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992726962 |
| Entity Type | Organization |
| Organization Name | BYU ID STUDENT HLTH CNTR PCHY |
| Other Organization Name | BYU-IDAHO STUDENT HEALTH CENTER PHARMACY |
| Practice Address |
179 Student Hlth Ctr Rexburg ID 83460-0001 |
| Practice Telephone | 2084969330 |
| Practice Fax Number | 2084969343 |
| Mailing Telephone | 2084969330 |
| Mailing Fax Number | 2084969343 |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2017-04-18 |
| Authorized Official Name | SHAWN ANDREASEN (PCHY DIR) |
| Authorized Official Telephone | 2084969330 |
| Authorized Official Credential | PHARMD RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
614RP | ID | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2020561 | 01 |
| Other Name | Type Code |
|---|---|
| BYU-IDAHO STUDENT HEALTH CENTER PHARMACY | Doing Business As Name - Organization |
| Street Address |
179 STUDENT HLTH CTR |
| City | REXBURG |
| State | ID |
| Zip Code | 83460-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407405111 | Analee Fish | Nurse Practitioner | Byui Student Health Center, Rexburg, ID 83460-0001 | 2019-09-05 |
| 1760923635 | Shawn Andreasen | Pharmacist | Byu Idaho Student Health Center 179 Ctr, Rexburg, ID 83460-0001 | 2017-03-13 |
| 1528097102 | Terry J. Anderson | Physician Assistant | 100 Shc Drive Byui, Rexburg, ID 83460-2010 | 2006-07-03 |
| 1558348649 | Hans Thurgood Redd | Internal Medicine | 100 Shc, Rexburg, ID 83460-2010 | 2005-12-29 |
| 1528044955 | David G Holland | Nurse Practitioner | Sch 100, Rexburg, ID 83460-2010 | 2005-12-19 |
| 1760467625 | Lori Ann Parker | Nurse Practitioner | Shc 100, Byu Idaho, Rexburg, ID 83460-2010 | 2005-12-13 |
| 1588654628 | Glade Southam | Nurse Practitioner | Byu - Idaho, 100 Shc, Rexburg, ID 83460-2010 | 2005-10-27 |
| 1538347034 | Byu Idaho Student Health Center | Clinic/Center | 100 Shc, Rexburg, ID 83460-2010 | 2008-02-06 |
| 1043297138 | Nancy Nadine Olsen | Nurse Practitioner | Shc 100, Rexburg, ID 83460-2010 | 2005-12-29 |
| 1831175231 | Jud E Miller | Family Medicine | Shc 100, Brigham Young University Idaho, Rexburg, ID 83460-2010 | 2005-12-16 |
| Find all providers in zip 83460 | ||||
| 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 |
| 1730351081 | Idaho State University | Pharmacy | 990 South 8th, Pocatello, ID 83209 | 2008-03-27 |
| 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 BYU ID STUDENT HLTH CNTR PCHY.
| 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.