BYU ID STUDENT HLTH CNTR PCHY NPI 1992726962

NPI Information

  • NPI: 1992726962
  • Provider Name: BYU ID STUDENT HLTH CNTR PCHY
  • Classification: Pharmacy - 3336C0002X
  • Specialization: Clinic Pharmacy
  • Entity Type: Organization
  • Doing Business As: BYU-IDAHO STUDENT HEALTH CENTER PHARMACY
  • CLIA Number: 13D0056537
  • Address: 179 STUDENT HLTH CTR
    REXBURG, ID
    ZIP 83460
  • Phone: (208) 496-9330

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NPI Details

BYU ID STUDENT HLTH CNTR PCHY is a clinic pharmacy pharmacy in Rexburg, 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. BYU ID STUDENT HLTH CNTR PCHY NPI is 1992726962. The provider is registered as an organization entity type.
The provider Is Doing Business As Byu-idaho Student Health Center Pharmacy.

The provider's business location address is:

179 STUDENT HLTH CTR
REXBURG, ID
ZIP 83460-001
Phone: (208) 496-9330
Fax: (208) 496-9343

The provider's authorized official is Shawn Andreasen .
The authorized official title is Pchy Dir and has the following contact phone number (208) 496-9330.

The CLIA number assigned to this NPI record is 13D0056537 - school/student health service with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 7/22/2006 and was last updated on 4/18/2017.

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
1333600000XPharmacyNo
23336C0003XPharmacyCommunity/Retail PharmacyNo
33336C0002XPharmacyClinic Pharmacy614RPIDAHOYes

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
12020561OTHERPK

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: 11/21/2025

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