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Contact Information

MOUNTAIN CARE PHARMACY IDAHO
1753 W BROADWAY ST
IDAHO FALLS, ID83402-3045
 Phone: 208-932-1260
 Fax: 208-523-2330
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Long Term Care Pharmacy

3336L0003X 58 Medical Supply Company with Pharmacist
 

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for MOUNTAIN CARE PHARMACY IDAHO

NPI Number 1588937395
LBN Legal business name MOUNTAIN CARE PHARMACY IDAHO
Authorized official JARED STONG - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/10/2012
Last updated 02/10/2012 - About 14 years ago
Identifiers
ID License # 18014LS
Other 1308661 NCPDP PROVIDER IDENTIFICATION NUMBER
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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