National Provider Identifier Database

INNOVATIVE CARE PHARMACY
Long Term Care Pharmacy

A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.


Contact Information

INNOVATIVE CARE PHARMACY
9196 E EMERALD ST
STE 110
BOISE, ID83704
Phone: 208-323-1259
Fax: 208-323-5666
Website:
Specialty Taxonomy Code
* Long Term Care Pharmacy 3336L0003X

* Indicates primary specialty

NPI Profile & details for INNOVATIVE CARE PHARMACY

NPI Number 1528055324
Legal business name
LBN
INNOVATIVE CARE PHARMACY
Authorized official BRAD LANHAM - (PRESIDENT/CEO)
Entity Organization
Organization subpart No
Enumeration date 10/05/2005
Last updated 05/07/2013 - About 13 years ago
Sole proprietor1 Not specified
Identifiers
  • ID License #: 2304LS
  • ID Medicaid: 80668600
  • Other: 2021877 PK

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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