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MEDICINE MAN WEST PHARMACY LLC NPI 1124193487


NPI Information

NPI: 1124193487
Provider Name: MEDICINE MAN WEST PHARMACY LLC

Doing Business As: MEDICINE MAN WEST PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 13D2152031

Address:
802 E MEDICAL CT
POST FALLS, ID
ZIP 83854
Phone: (208) 773-3566
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MEDICINE MAN WEST PHARMACY LLC is a community/retail pharmacy pharmacy in Post Falls, ID. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. MEDICINE MAN WEST PHARMACY LLC NPI is 1124193487. The provider is registered as an organization entity type.
The provider Is Doing Business As Medicine Man West Pharmacy.

The provider's business location address is:

802 E MEDICAL CT
POST FALLS, ID
ZIP 83854-298
Phone: (208) 773-3566
Fax: (208) 777-8239

The provider's authorized official is Donald Smith .
The authorized official title is Owner and has the following contact phone number (208) 773-3566.

The CLIA number assigned to this NPI record is 13D2152031 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/22/2006 and was last updated on 9/16/2013.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
23336C0004XPharmacyCompounding PharmacyNo
3333600000XPharmacyNo
43336C0003XPharmacyCommunity/Retail Pharmacy719CPIDAHOYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11304411OTHERNCPDP PROVIDER IDENTIFICATION NUMBER
220002785MEDICARE PINIDAHO
30487930001MEDICARE NSCIDAHO
420002785OTHERIDAHOMEDICARE PART B
5002599400MEDICAIDIDAHO

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.