MEDICINE MAN NORTH PHARMACY INC (NPI# 1851894380) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851894380 |
| Entity Type | Organization |
| Organization Name | MEDICINE MAN NORTH PHARMACY INC |
| Other Organization Name | MEDICINE MAN ATHOL PHARMACY |
| Practice Address |
30585 N Roberts Rd Hayden ID 83835 |
| Mailing Address |
Po Box 1706 Hayden ID 83835-1706 |
| Practice Telephone | 2086831309 |
| Practice Fax Number | 2086831315 |
| Mailing Telephone | 2086831309 |
| Mailing Fax Number | 2086831315 |
| Enumeration Date | 2018-03-11 |
| Last Update Date | 2018-05-15 |
| Authorized Official Name | BARRY FEELY (PRES) |
| Authorized Official Telephone | 2086999337 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
47570RP | ID | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2176449 | 01 | |
| ID | 1851894380 | 05 |
| Other Name | Type Code |
|---|---|
| MEDICINE MAN ATHOL PHARMACY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821159997 | Medicine Man North Pharmacy Inc | Pharmacy | 240 W Hayden Ave, Hayden, ID 83835-8194 | 2006-12-13 |
| 1023179892 | Medicine Man North Pharmacy Inc | Pharmacy | 8093 N Cornerstone Dr, Hayden, ID 83835-8753 | 2006-12-13 |
| Street Address |
30585 N ROBERTS RD |
| City | HAYDEN |
| State | ID |
| Zip Code | 83835 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881212371 | Ngan T Nguyen | Pharmacist | 161 E. Prairie Shopping Center, Hayden, ID 83835 | 2020-07-10 |
| 1689158461 | Rskiom, Pllc | Electrodiagnostic Medicine | 9323 N Government Way #6, Hayden, ID 83835 | 2018-09-18 |
| 1235616913 | Kimberly Jill Young | Dietitian, Registered | 8500 N. Atlas Rd., Hayden, ID 83835 | 2018-07-25 |
| 1366997322 | Jennifer Amber Belmont | Social Worker | 8680 N Wayne Dr, Suite A, Hayden, ID 83835 | 2016-08-19 |
| 1548637994 | Dance Dentistry Pllc | Clinic/Center | 1027 W Prairie Ave, Hayden, ID 83835 | 2015-09-01 |
| 1982012498 | Dallin J. Dance | Dentist | 1027 W. Prairie Ave., Hayden, ID 83835 | 2014-07-28 |
| 1669808614 | Integrated Interventions LLC | Clinic/Center | 2482 E. Glacier Rd., Hayden Lake, ID 83835 | 2013-09-23 |
| 1669812301 | Caleb Jerome Foss | Physical Therapist | 8382 N Wayne Dr Ste 100, Hayden, ID 83835 | 2013-06-26 |
| 1437493798 | Joseph Neal Tessendorf | Chiropractor | 1401 Biztown Loop, Hayden, ID 83835 | 2012-11-26 |
| 1881938777 | North Star Physical Therapy and Wellness | Clinic/Center | 8944 N. Hess St, Suite B, Hayden, ID 83835 | 2012-11-16 |
| Find all providers in zip 83835 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| 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 |
|---|---|---|---|---|
| 1992935696 | Walgreen Co | Pharmacy | 260 W Honeysuckle Ave, Hayden, ID 83835-9270 | 2009-07-16 |
| 1639160732 | Hayden Family Pharmacy P C | Pharmacy | 4086 State Highway 160, Hayden, AL 35079-6551 | 2005-10-30 |
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|---|---|---|---|---|
| 1295336709 | Family Health Services Pharmacy | Pharmacy | 218 W. Nez Perce, Jerome, ID 83338 | 2020-11-03 |
| 1841806494 | Deblaquiere Enterprises, Inc. | Pharmacy | 86 Tank Rd, Oldtown, ID 83822-5126 | 2020-09-18 |
| 1043838584 | Costco Wholesale Corporation | Pharmacy | 3403 W Chinden Blvd, Meridian, ID 83646-7151 | 2020-07-10 |
| 1265054324 | Costco Wholesale Corporation | Pharmacy | 2495 E Lincoln Rd, Idaho Falls, ID 83401-2203 | 2020-05-12 |
| 1851923544 | Rocky Mountain Pharmacy, LLC | Pharmacy | 3910 Washington Pkwy Ste A, Idaho Falls, ID 83404-7884 | 2020-02-10 |
| 1013559269 | Timberline Pharmacy | Pharmacy | 4574 N Ten Mile Rd Ste 110, Meridian, ID 83646-6930 | 2019-10-09 |
| 1508420373 | K2red LLC | Pharmacy | 447 N Idaho St, Wendell, ID 83355 | 2019-04-27 |
| 1679039135 | Hollis Family Pharmacy LLC | Pharmacy | 845 S Substation Rd, Emmett, ID 83617 | 2019-02-20 |
| 1598229809 | Clearwater Canyon Pharmacy, LLC | Pharmacy | 13020 Us-12, Orofino, ID 83544 | 2019-01-31 |
| 1861999377 | Bi-mart Corporation | Pharmacy | 11347 W State Street, Star, ID 83669 | 2018-04-11 |
| Find all providers with the same taxonomy | ||||
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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.