IDAHO CVS PHARMACY LLC (NPI# 1841212636) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841212636 |
| Entity Type | Organization |
| Organization Name | IDAHO CVS PHARMACY LLC |
| Other Organization Name | CVS PHARMACY #16216 |
| Practice Address |
1611 Blue Lakes Blvd N Twin Falls ID 83301-3374 |
| Mailing Address |
1 Cvs Dr Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 2087363321 |
| Practice Fax Number | 2089443425 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2016-10-31 |
| Authorized Official Name | SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS) |
| Authorized Official Telephone | 4017702751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
41102RP | ID | Suppliers |
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2021933 | 01 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #16216 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336249648 | Idaho Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 16300 N Marketplace Blvd, Nampa, ID 83687-7910 | 2006-09-25 |
| 1265912901 | Idaho Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 7402 W Fairview Ave, Boise, ID 83704-8411 | 2018-08-21 |
| Street Address |
1611 BLUE LAKES BLVD N |
| City | TWIN FALLS |
| State | ID |
| Zip Code | 83301-3374 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245840586 | Dorothy Burnham | Pharmacist | 1611 Blue Lakes Blvd N, Twin Falls, ID 83301-3374 | 2020-08-02 |
| 1801359179 | Blake Sommers Nielsen | Pharmacist | 1611 Blue Lakes Blvd N, Twin Falls, ID 83301-3374 | 2019-04-12 |
| 1366902926 | Doaa Alzahraa Alsoudani | Pharmacist | 1611 Blue Lakes Blvd N, Twin Falls, ID 83301-3374 | 2019-03-20 |
| 1144723420 | Bryce William Bennion | Pharmacist | 1611 Blue Lakes Blvd N, Twin Falls, ID 83301-3374 | 2018-03-13 |
| 1790230092 | Janet Mayo | Pharmacist | 1611 Blue Lakes Blvd N, Twin Falls, ID 83301-3374 | 2016-08-17 |
| 1043694425 | Jessica Vickers | Pharmacist | 1611 Blue Lakes Blvd N, Twin Falls, ID 83301-3374 | 2015-07-15 |
| 1467747642 | Karen E Franklin | Pharmacist | 1611 Blue Lakes Blvd N, Twin Falls, ID 83301-3374 | 2011-06-15 |
| 1003100116 | Tony Dean Rost | Pharmacist | 1611 Blue Lakes Blvd N, Twin Falls, ID 83301-3374 | 2011-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023645918 | Matthew Anderson | Pharmacist | Dick's Pharmacy, 526 K Shoup Ave W, Twin Falls, ID 83301 | 2020-03-23 |
| 1780146316 | Frontier Pediatric Partners, Pllc | Pediatrics | 1502 Locust Street N #700, Twin Falls, ID 83301 | 2019-04-02 |
| 1972073377 | Wood River Acupuncture | Acupuncturist | 1625 Addison Ave East, Twin Falls, ID 83301 | 2018-11-28 |
| 1235629874 | Lonnie Paul | Counselor | 1092 Eastland Dr N Ste A, Twin Falls, ID 83301 | 2018-05-17 |
| 1679060966 | Christina Jirapha Thongdee | Social Worker | 625 Poleline Road West, Suite 2a, Twin Falls, ID 83301 | 2018-04-23 |
| 1437658499 | Tyrel Kevin Ward | Chiropractor | 2167 Village Park Ave., Suite 100, Twin Falls, ID 83301 | 2018-02-06 |
| 1851836381 | Tanabell Health Services, Inc | Skilled Nursing Facility | 1134 Cheney Drive West, Twin Falls, ID 83301 | 2016-12-19 |
| 1578005195 | Matthew Carter | Physical Therapist | 1053 Eastland Drive, Twin Falls, ID 83301 | 2016-11-14 |
| 1790227783 | Murvat Usmanova | Nurse Practitioner | 775 Pole Line Road W, Suite 203, Twin Falls, ID 83301 | 2016-11-08 |
| 1265894687 | Shawna Fultz | Social Worker | 1201 Fall Ave East Suite C, Twin Falls, ID 83301 | 2016-03-24 |
| Find all providers in zip 83301 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| 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: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609931039 | T2 Apothecary | Pharmacy | 615 Filer Ave, Twin Falls, ID 83301-4008 | 2006-12-26 |
| 1578656914 | David Nelson | Pharmacy | 139 Main Ave W, Twin Falls, ID 83301-6160 | 2006-09-30 |
| 1326158932 | Costco Wholesale Corporation | Pharmacy | 731 Pole Line Rd, Twin Falls, ID 83301 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043878598 | Legranderx Pharmacy LLC | Pharmacy | 343 E 4th N Ste 126, Rexburg, ID 83440-6004 | 2019-05-30 |
| 1386202026 | Genoa Healthcare, LLC | Pharmacy | 2705 E 17th St Ste S5, Ammon, ID 83406-6601 | 2019-05-29 |
| 1669935813 | Broulim Supermarkets, LLC | Pharmacy | 301 Aspen Sq, Saint Anthony, ID 83445-1662 | 2019-04-12 |
| 1851894380 | Medicine Man North Pharmacy Inc | Pharmacy | 30585 N Roberts Rd, Hayden, ID 83835 | 2018-03-11 |
| 1881194090 | Doc's Pharmacy2 LLC | Pharmacy | 16438 N Highway 41, Rathdrum, ID 83858-6888 | 2018-02-14 |
| 1508365958 | P. Roman Burk Dpm PC | Pharmacy | 2667 E. Gala Court Suite 125, Meridian, ID 83642 | 2018-02-12 |
| 1053860767 | Gooding Pharmacy Inc | Pharmacy | 120 South Apple, Suite A, Shoshone, ID 83352 | 2016-09-23 |
| 1649644584 | Yokes Foods Inc | Pharmacy | 1501 E Seltice Way, Post Falls, ID 83854-7531 | 2015-11-16 |
| 1629452776 | Shopko Stores Operating Co., LLC | Pharmacy | 429 Michigan Ave, Orofino, ID 83544-0000 | 2015-07-17 |
| 1164811402 | Ashton Memorial, Inc | Pharmacy | 23 S. 8th St., Ashton, ID 83420 | 2015-01-09 |
| Find all providers with the same taxonomy | ||||
| City | TWIN FALLS |
| Zip Code | 83301 |
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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.