DR. PAUL ALTON BLACK (NPI# 1174515399) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174515399 |
| Entity Type | Individual |
| Full Name | DR. PAUL ALTON BLACK |
| Credential | PHARM.D. |
| Practice Address |
500 W Fort St Boise ID 83702-4501 |
| Mailing Address |
1931 E Dworshak Dr Meridian ID 83642-6779 |
| Practice Telephone | 2084221000 |
| Mailing Telephone | 2088887275 |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P1200X |
Pharmacist Specialization: Pharmacotherapy |
P5371 | ID | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295040020 | Paul Lelan Black | Internal Medicine | 3588 7th Ave, San Diego, CA 92103-5009 | 2010-08-17 |
| 1871618678 | Paul H Black | Internal Medicine | Boston Univ Sch of Med, 715 Albany St, Boston, MA 02118 | 2007-03-20 |
| 1609903053 | Paul Steven Black | Optometrist | 111 D Interstate 45 So, Huntsville, TX 77340 | 2007-02-27 |
| 1104446897 | Paul Black | Counselor | 78 S Main St, Rutland, VT 05701-4594 | 2020-04-22 |
| 1225367386 | Paul Alan Black | Pharmacist | 5960 Fm 1103, New Braunfels, TX 78132 | 2009-12-18 |
| 1609030618 | Paul N Black | Psychologist | 20740 S Ellsworth Rd, Queen Creek, AZ 85242-9058 | 2008-07-18 |
| 1285825836 | Paul Clifford Black | Family Medicine | 1000 Gw Ln, Waynesville, MO 65583-2339 | 2007-08-08 |
| 1164631263 | Paul Laurence Black | Dentist | 60 Hodges Ave, Dental Clinic, Taunton, MA 02780-3034 | 2007-05-22 |
| 1336351600 | Paul Robert Black | Pharmacist | 1600 11th St, Wichita Falls, TX 76301-4300 | 2007-05-07 |
| 1427101567 | Paul Ralph Black Jr. | Dentist | 2525 Kimberly Rd, Suite#3, Bettendorf, IA 52722-3538 | 2007-01-20 |
| Street Address |
500 W FORT ST |
| City | BOISE |
| State | ID |
| Zip Code | 83702-4501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063411007 | Sandra Gee Jue | Pharmacist | 500 W Fort St, Bldg 44a, Boise, ID 83702-4501 | 2005-07-20 |
| 1952902389 | Christine Alice Walsh | Recreation Therapist | 500 W Fort St, Boise, ID 83702-4501 | 2020-11-03 |
| 1386243160 | Elizabeth Larsen | Registered Nurse | 500 W Fort St, Boise, ID 83702-4598 | 2020-10-22 |
| 1013516293 | Rebecca Cotterell | Registered Nurse | 500 W Fort St, Boise, ID 83702-4501 | 2020-10-20 |
| 1487253670 | Morgan Wussow | Registered Nurse | 500 W Fort St, Boise, ID 83702-4501 | 2020-10-20 |
| 1548867435 | Justin Hyer | Registered Nurse | 500 W Fort St, Boise, ID 83702-4501 | 2020-10-05 |
| 1881209336 | Daniel James Councell | Physician Assistant | 500 W Fort St, Boise, ID 83702-4501 | 2020-09-11 |
| 1508470451 | Marcus J Day | Registered Nurse | 500 W Fort St, Boise, ID 83702-4501 | 2020-09-08 |
| 1386258291 | Vanessa Potoski | Registered Nurse | 500 W Fort St, Boise, ID 83702-4501 | 2020-09-08 |
| 1033723788 | Brian Lynn Lambrecht | Licensed Practical Nurse | 500 W Fort St, Boise, ID 83702-4501 | 2020-09-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790321966 | Inland Northwest Neuromonitoring Pllc | Psychiatry & Neurology | 950 Bannock Street, Suite 1100, Boise, ID 83702 | 2019-11-22 |
| 1508359084 | Emily Cook | Dietitian, Registered | St. Luke's Rehab Hospital, 600 N Robbins Road, Bosie, ID 83702 | 2018-06-11 |
| 1265925887 | Marla Braendle | Dietitian, Registered | St. Luke's Rehabilitation Hospital, 600 N. Robbins Road, Boise, ID 83702 | 2018-06-08 |
| 1114419678 | Sidrah Khan Psychotherapy PC | Social Worker | 242 N 8th St, Suite 200, Boise, ID 83702 | 2018-05-31 |
| 1508386707 | Emp Idaho Nampa, LLC | General Acute Care Hospital | 350 E Myrtle Street, Suite 100, Boise, ID 83702 | 2017-06-20 |
| 1194264077 | Karen Mangum | Dietitian, Registered | 115 N. Main Street, Suite #203, Boise, ID 83702 | 2017-02-13 |
| 1750828422 | Stephen Pyper | Massage Therapist | 14089 Main St #100, Boise, ID 83702 | 2017-01-19 |
| 1427504398 | The Young Mens Christian Association of Boise City Idaho | Health Educator | 419 N 11th St, Boise, ID 83702 | 2016-08-30 |
| 1942756838 | Brent Hiroshi Sasaki | Pharmacist | 500 West Fort Street (119), Boise, ID 83702 | 2016-08-30 |
| 1578912051 | Marnae Walker | Counselor | 509 S. 14th St, Suite 2, Boise, ID 83702 | 2016-06-06 |
| Find all providers in zip 83702 | ||||
| Taxonomy Code | 1835P1200X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacotherapy |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing pharmacotherapeutic care of patients, by developing, implementing, monitoring, and modifying complex treatment plans, providing advanced level education and consultation, and collaborating with other health professionals in the management of therapy. |
| Notes: Source: Specialty certification and recertification program administered by Board of Pharmaceutical Specialties, www.bpsweb.org [7/1/2006: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679817811 | Robert Wills | Pharmacist | 1001 W Resseguie St, Boise, ID 83702-4106 | 2012-11-10 |
| 1528052008 | The Pharmacy Doctor, Inc. | Pharmacist | 1471 Shoreline Dr, Suite 100, Boise, ID 83702-6879 | 2005-09-09 |
| 1700396975 | Michael Tyler Hemsley | Pharmacist | 805 W Franklin St, Boise, ID 83702-5560 | 2017-10-02 |
| 1902068133 | Lindsay M Black | Pharmacist | 500 W Fort St, Boise, ID 83702-4501 | 2008-06-29 |
| 1013127109 | Catherine M Oliphant | Pharmacist | 300 E Jefferson St, Suite 201, Boise, ID 83712-6246 | 2007-05-23 |
| 1780804435 | C. Dustin Waters | Pharmacist | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2007-04-26 |
| 1023237583 | Catherine A Gundlach | Pharmacist | 190 E Bannock St, Inpatient Pharmacy, Boise, ID 83712-6241 | 2007-04-24 |
| 1407071277 | Jim V Nguyen | Pharmacist | 190 E Bannock St, Boise, ID 83712-6241 | 2007-04-16 |
| 1346259132 | Jared J Alexander | Pharmacist | 500 W Fort St, Boise, ID 83702-4501 | 2006-08-08 |
| 1720021132 | Stephanie Shumaker | Pharmacist | 190 E Bannock St, Boise, ID 83712-6241 | 2006-06-14 |
| Find all providers in BOISE | ||||
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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.