National Provider Identifier Database

PURE PATH COMPOUNDING PHARMACY LLC
Compounding Pharmacy

A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner?s Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice.


Contact Information

PURE PATH COMPOUNDING PHARMACY LLC
2141 W AIRPORT WAY STE 700
BOISE, ID83705-5168
Phone: 208-985-3575
Fax:
Website:
Specialty Taxonomy Code
* Compounding Pharmacy 3336C0004X
Home Infusion Therapy Pharmacy 3336H0001X
Mail Order Pharmacy 3336M0002X
Specialty Pharmacy 3336S0011X

* Indicates primary specialty

NPI Profile & details for PURE PATH COMPOUNDING PHARMACY LLC

NPI Number 1033917810
Legal business name
LBN
PURE PATH COMPOUNDING PHARMACY LLC
Authorized official KEVIN CRUMLEY - (OPERATIONS MANAGER)
Entity Organization
Organization subpart No
Enumeration date 03/06/2025
Last updated 03/24/2025 - More than a year ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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