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IDAHO STATE UNIVERSITY NPI 1730351081


NPI Information

NPI: 1730351081
Provider Name: IDAHO STATE UNIVERSITY

Doing Business As: IDAHO STATE UNIVERSITY STUDENT HEALTH CENTER PHARMACY

Classification: Pharmacy - 3336C0002X
Entity Type: Organization

Specialization: Clinic Pharmacy

Address:
990 SOUTH 8TH
POCATELLO, ID
ZIP 83209
Phone: (208) 282-3407
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IDAHO STATE UNIVERSITY is a clinic pharmacy pharmacy in Pocatello, 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. IDAHO STATE UNIVERSITY NPI is 1730351081. The provider is registered as an organization entity type.
The provider Is Doing Business As Idaho State University Student Health Center Pharmacy.

The provider's business location address is:

990 SOUTH 8TH
POCATELLO, ID
ZIP 83209
Phone: (208) 282-3407

The provider's authorized official is Gina Davis .
The authorized official title is Pharmacy Manager and has the following contact phone number (208) 282-3407.

The enumeration date for this NPI number is 3/27/2008 and was last updated on 2/3/2012.


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
13336C0002XPharmacyClinic Pharmacy349CPIDAHOYes

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
11307974OTHERNCPDP PROVIDER IDENTIFICATION NUMBER

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

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