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Contact Information

CROSS LTC PHARMACY, LLC
4990 VALENTY RD
SUITE A1
CHUBBUCK, ID83202-1883
 Phone: 208-403-0084
 Fax: 208-403-0361
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Long Term Care Pharmacy

3336L0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for CROSS LTC PHARMACY, LLC

NPI Number 1619306214
LBN Legal business name CROSS LTC PHARMACY, LLC
Authorized official BLAKE BUFFAT - (DIRECTOR OF PHARMACY)
Entity Organization
Organization subpart 1 No
Enumeration date 11/04/2013
Last updated 12/09/2025 - About 6 months ago
Identifiers
ID License # 33793LS
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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