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MEDICAL CLINIC PHARMACY INC NPI 1962581652


NPI Information

NPI: 1962581652
Provider Name: MEDICAL CLINIC PHARMACY INC

Doing Business As: MEDICAL CLINIC PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 13D2150047

Address:
315 E ELM ST
SUITE150
CALDWELL, ID
ZIP 83605
Phone: (208) 459-1503
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MEDICAL CLINIC PHARMACY INC is a community/retail pharmacy pharmacy in Caldwell, 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. MEDICAL CLINIC PHARMACY INC NPI is 1962581652. The provider is registered as an organization entity type.
The provider Is Doing Business As Medical Clinic Pharmacy.

The provider's business location address is:

315 E ELM ST
SUITE150
CALDWELL, ID
ZIP 83605-857
Phone: (208) 459-1503
Fax: (208) 459-1504

The provider's authorized official is Tyler Higgins .
The authorized official title is President and has the following contact phone number (208) 459-1503.

The CLIA number assigned to this NPI record is 13D2150047 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/3/2006 and was last updated on 7/19/2018.


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
13336C0004XPharmacyCompounding PharmacyNo
2333600000XPharmacyNo
33336C0003XPharmacyCommunity/Retail Pharmacy2373RPIDAHOYes

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
11962581652MEDICAIDIDAHO
22123594OTHERPK

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.