KOOTENAL HEALTH (NPI# 1073835591) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1073835591 |
Entity Type | Organization |
Organization Name | KOOTENAL HEALTH |
Other Organization Name | KOOTENAI CLINICS CANCER SERVICES PHARMACY |
Practice Address |
700 W Ironwood Dr Coeur D Alene ID 83814-2656 |
Mailing Address |
700 W Ironwood Dr Ste 228 Coeur D Alene ID 83814-2656 |
Practice Telephone | 2086255670 |
Practice Fax Number | 2086255669 |
Mailing Telephone | 2086255670 |
Mailing Fax Number | 2086255669 |
Enumeration Date | 2010-02-25 |
Last Update Date | 2016-01-11 |
Authorized Official Name | KELLEY GRIFFITH (DIRECTOR OF PHARMACY) |
Authorized Official Telephone | 2086255626 |
Authorized Official Credential | RPH |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
N | 333600000X | Pharmacy | Suppliers | ||
Y | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
1198LS | ID | Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
ID | 1073835591 | 05 | |
PK | 2124398 | 01 |
Other Name | Type Code |
---|---|
Kootenai Clinics Cancer Services Pharmacy | Doing Business As Name - Organization |
Street Address |
700 W IRONWOOD DR |
City | COEUR D ALENE |
State | ID |
Zip Code | 83814-2656 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699771451 | Ronald J Stout | Otolaryngology | 700 W Ironwood Dr, Ste 236, Coeur D Alene, ID 83814-4484 | 2005-06-24 |
1033635180 | Jamie Lee Park | Pharmacist | 700 W Ironwood Dr, Coeur D Alene, ID 83814-2656 | 2017-08-21 |
1063944726 | Mandi Nordhagen | Pharmacist | 700 W Ironwood Dr, Suite 228, Coeur D Alene, ID 83814-2656 | 2017-03-31 |
1679004675 | Jamie Cervi-skinner | Pharmacist | 700 W Ironwood Dr, Suite 246, Coeur D Alene, ID 83814-2656 | 2017-03-22 |
1982144424 | Carissa Hober | Pharmacist | 700 W Ironwood Dr, Suite 246, Coeur D Alene, ID 83814-2656 | 2017-03-02 |
1861939910 | Kellie Kathryn Breaux | Nurse Practitioner | 700 W Ironwood Dr, Suite 155, Coeur D Alene, ID 83814-2656 | 2017-01-27 |
1902348709 | Michael Watrobka | Physician Assistant | 700 W Ironwood Dr, Suite 120e, Coeur D Alene, ID 83814-2656 | 2016-11-09 |
1841748530 | Elizabeth St John | Physician Assistant | 700 W Ironwood Dr, Ste 341, Coeur D Alene, ID 83814-2656 | 2016-09-12 |
1184076465 | Craig Allred | Audiologist | 700 W Ironwood Dr, Ste 278, Coeur D Alene, ID 83814-2656 | 2016-07-11 |
1962869008 | Natalie Jeane Bartell | Nurse Practitioner | 700 W Ironwood Dr, Suite 155, Coeur D Alene, ID 83814-2656 | 2016-01-20 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477162675 | Dehra Mcfaddan | Social Worker | 211 E. Coeur D'alene Ave, 102, Coeur D Alene, ID 83814 | 2020-07-24 |
1043838634 | Yendi Labelle | Nurse Practitioner | 1115 N Ironwood Drive, Coeur D'alene, ID 83814 | 2020-07-09 |
1295353217 | Cultivation, LLC | Counselor | 211 E. Coeur Dalene Ave. Ste 102, Coeur D'alene, ID 83814 | 2020-07-07 |
1306487517 | Northwest Integrated Health, LLP | Clinic/Center | 1250 West N. Northwood Center Ct, Suite B, Coeur D'alene, ID 83814 | 2019-09-30 |
1730740465 | Connor Williams | Physical Therapist | 1812 W Lakewood Dr, Ste. 100, Coeur D Alene, ID 83814 | 2019-06-24 |
1912480153 | Nadine M Lewis | Social Worker | 211 E. Coeur D'alene Ave., Coeur D'alene, ID 83814 | 2018-09-13 |
1992208631 | Orthopedic Surgery and Sports | Orthopaedic Surgery | 1812 N Lakewood Drive, Suite 100, Coeur D'alene, ID 83814 | 2018-03-08 |
1346758042 | Heather Marie Johnson | Counselor | 7905 Meadowlark Way, Cda, ID 83814 | 2018-01-16 |
1881113413 | Brevity Treatment Services | Counselor | 2201 N. Government Way Ste. L, Coeur D'alene, ID 83814 | 2017-09-14 |
1366969628 | Jennifer La Gina Highfield | Massage Therapist | 1104 N Ste B, Coeur D Alene, ID 83814 | 2017-08-28 |
Find all providers in zip 83814 |
Taxonomy Code | 3336C0002X |
Grouping | Suppliers |
Classification | Pharmacy |
Specialization | Clinic Pharmacy |
A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. |
Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164035689 | Allergy Butler, LLC | Pharmacy | 1611 12th Ave Rd Ste A, Nampa, ID 83686-6182 | 2020-08-25 |
1922312842 | Teton Valley Hospital Pharmacy | Pharmacy | 120 East Howard Ave., Driggs, ID 83422-5112 | 2010-08-03 |
1730351081 | Idaho State University | Pharmacy | 990 South 8th, Pocatello, ID 83209 | 2008-03-27 |
1740717693 | Snake River Pharmacy | Pharmacy | 4750 Yellowstone Ave, Chubbuck, ID 83202-2336 | 2017-05-22 |
1184163511 | Bear Lake Community Health Center Pharmacy - 340b | Pharmacy | 152 S 4th St, Montpelier, ID 83254-1538 | 2017-02-17 |
1942615828 | Family Health Services Pharmacy | Pharmacy | 388 Martin Street, Family Health Services Pharmacy, Twin Falls, ID 83301-6856 | 2014-06-30 |
1669616272 | Community Health Clinics, Inc. | Pharmacy | 300 S 23rd St, Boise, ID 83702-9100 | 2009-04-27 |
1316156482 | Community Health Clinics, Inc. | Pharmacy | 802 Cleveland Blvd, Caldwell, ID 83605 | 2007-05-22 |
1770687188 | Community Health Clinics, Inc | Pharmacy | 223 16th Ave N, Nampa, ID 83687-4058 | 2006-09-08 |
City | COEUR D ALENE |
Zip Code | 83814 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.