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Contact Information

PHARMACY SHOP INC
1015 E YOUNG
POCATELLO, ID83201
 Phone: 208-232-0049
 Fax: 208-232-3963
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for PHARMACY SHOP INC

NPI Number 1295897171
LBN Legal business name PHARMACY SHOP INC
Authorized official EDWARD SNELL - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 12/15/2006
Last updated 06/06/2008 - About 18 years ago
Identifiers
ID License # 801CP
ID Medicaid 002631600
ID Other 002631400 MEDICAID
ID Other 8C451 PRIVATE INS BLUE CROSS
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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