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Contact Information

STATE OF IDAHO-DBA IDAHO STATE SCHOOL & HOSPITAL PHARMACY
1660 11TH AVE N
NAMPA, ID83687-5000
 Phone: 208-442-2812
 Fax: 208-467-3406
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Institutional Pharmacy

3336I0012X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for STATE OF IDAHO-DBA IDAHO STATE SCHOOL & HOSPITAL PHARMACY

NPI # 1265559314
LBN Legal business name STATE OF IDAHO-DBA IDAHO STATE SCHOOL & HOSPITAL PHARMACY
Authorized official SUSAN BROETJE - (ADMINISTRATIVE DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 03/23/2007
Last updated 08/22/2020 - About 6 years ago
Identifiers
ID License # 539-HP
ID Medicaid 0028335600
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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