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Contact Information

BYU ID STUDENT HLTH CNTR PCHY
179 STUDENT HLTH CTR
REXBURG, ID83460-0001
 Phone: 208-496-9330
 Fax: 208-496-9343
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinic Pharmacy

3336C0002X 58 Medical Supply Company with Pharmacist
 

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for BYU ID STUDENT HLTH CNTR PCHY

NPI Number 1992726962
LBN Legal business name BYU ID STUDENT HLTH CNTR PCHY
Authorized official SHAWN ANDREASEN - (PCHY DIR)
Entity Organization
Organization subpart 1 No
Enumeration date 07/22/2006
Last updated 04/18/2017 - About 9 years ago
Identifiers
ID License # 614RP
Other 2020561 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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