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Contact Information

IDAHO STATE UNIVERSITY
208 CENTER ST.
MCCAMMON, ID83250
 Phone: 208-282-6155
 Fax: 208-254-9372
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for IDAHO STATE UNIVERSITY

NPI Number 1083393284
LBN Legal business name IDAHO STATE UNIVERSITY
Authorized official CYNTHIA ROCK - (CLINICS DIRECTOR OF OPERATIONS)
Entity Organization
Organization subpart 1 No
Enumeration date 07/14/2023
Last updated 07/09/2024 - More than a year ago
Identifiers n/a
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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