KOOTENAI HEALTH INC. NPI 1073835591

NPI Information

NPI: 1073835591
Provider Name: KOOTENAI HEALTH, INC.

Doing Business As: KOOTENAI CLINICS CANCER SERVICES PHARMACY

Classification: Pharmacy - 3336C0002X
Entity Type: Organization

Specialization: Clinic Pharmacy

Address:
700 W IRONWOOD DR
COEUR D ALENE, ID
ZIP 83814
Phone: (208) 625-5670
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KOOTENAI HEALTH, INC. is a clinic pharmacy pharmacy in Coeur D Alene, ID. The provider is a pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. KOOTENAI HEALTH, INC. NPI is 1073835591. The provider is registered as an organization entity type.
The provider Is Doing Business As Kootenai Clinics Cancer Services Pharmacy.

The provider's business location address is:

700 W IRONWOOD DR
COEUR D ALENE, ID
ZIP 83814-656
Phone: (208) 625-5670
Fax: (208) 625-5669

The provider's authorized official is Jon Ness .
The authorized official title is Ceo and has the following contact phone number (208) 625-5081.

The enumeration date for this NPI number is 2/25/2010 and was last updated on 1/5/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	332B00000X	Durable Medical Equipment & Medical Supplies				No
2	333600000X	Pharmacy				No
3	3336S0011X	Pharmacy	Specialty Pharmacy			No
4	3336C0002X	Pharmacy	Clinic Pharmacy	1198LS	IDAHO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1073835591	MEDICAID	IDAHO
2	2124398	OTHER		PK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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