BEAR LAKE COMMUNITY HEALTH CENTER


Address: 152 S 4th St, Montpelier, ID 83254-1538
Phone: 2089043600

BEAR LAKE COMMUNITY HEALTH CENTER (NPI# 1861949679) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1861949679
Entity Type Organization
Organization Name BEAR LAKE COMMUNITY HEALTH CENTER
Other Organization Name BEAR LAKE COMMUNITY HEALTH CENTER - MONTPELIER
Practice Address 152 S 4th St
Montpelier
ID 83254-1538
Mailing Address 1047 S 100 W Ste 270
Logan
UT 84321-6790
Practice Telephone 2089043600
Practice Fax Number 2089040556
Mailing Telephone 4357558424
Mailing Fax Number 4357558436
Enumeration Date 2016-09-09
Last Update Date 2017-04-13
Authorized Official Name MELISSA DUCE (PHARMACY OFFICE MANAGER)
Authorized Official Telephone 4357558424
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 333600000X Pharmacy Suppliers
N 3336C0003X Pharmacy
Specialization: Community/Retail Pharmacy
Suppliers
Y 3336C0002X Pharmacy
Specialization: Clinic Pharmacy
44396RP ID Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
ID 1861949679 05
PK 2167754 01

Other Provider/Organization Names

Other Name Type Code
Bear Lake Community Health Center - Montpelier Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1336705755 Bear Lake Community Health Center Pharmacy 517 W 100 N Ste 210, Providence, UT 84332-9826 2019-05-10
1285140376 Bear Lake Community Health Center Pharmacy 75 Yellow Creek Rd Ste 102, Evanston, WY 82930-5205 2017-12-27
1922514017 Bear Lake Community Health Center Pharmacy 2620 Commercial Way Ste 121, Rock Springs, WY 82901-4746 2017-12-27
1568732501 Bear Lake Community Health Center Pharmacy 75 Yellow Creek Rd # S-102, Evanston, WY 82930-5235 2012-01-09
1083886865 Bear Lake Community Health Center Pharmacy 1515 N 400 E, Suite 104, North Logan, UT 84341-7561 2008-04-01
1689754475 Bear Lake Community Health Center Clinic/Center 325 W. Logan Hwy, Garden City, UT 84028-0328 2006-10-16
1740383884 Bear Lake Community Health Center Pharmacy 325 W Logan Hwy, Garden City, UT 84028 2006-09-06
1063940344 Bear Lake Community Health Center Clinic/Center 2620 Commercial Way, Rock Springs, WY 82901-4671 2017-05-31
1558806125 Bear Lake Community Health Center Clinic/Center 5 W 200 N, Brigham City, UT 84302-2109 2017-01-05
1003264664 Bear Lake Community Health Center Clinic/Center 152 S 4th St, Montpelier, ID 83254-1538 2016-05-24

Other Data Sources

Entity Type Entity Name Entity Address
System for Award Management (SAM) Entities BEAR LAKE COMMUNITY HEALTH CENTER, INC. 325 W Logan Hwy, Garden City, UT 84028

Office Location

Street Address 152 S 4TH ST
City MONTPELIER
State ID
Zip Code 83254-1538

Providers in the same location

NPI Name Taxonomy Address Enumeration
1932200391 Heidi Yvonne Walker Physician Assistant 152 S 4th St, Montpelier, ID 83254-1538 2006-09-26
1033603345 Sydnie M Hobbs Nurse Practitioner 152 S 4th St, Montpelier, ID 83254 2018-06-20
1184163511 Bear Lake Community Health Center Pharmacy - 340b Pharmacy 152 S 4th St, Montpelier, ID 83254-1538 2017-02-17
1003264664 Bear Lake Community Health Center Clinic/Center 152 S 4th St, Montpelier, ID 83254-1538 2016-05-24
1336512714 Mark Berning Pharmacist 152 S 4th St, Montpelier, ID 83254-1538 2015-11-05
1386829687 Mina L Wayman Nurse Practitioner 152 S 4th St, Montpelier, ID 83254-1538 2008-01-04

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1366597866 Joseph F Decker Professional Corp Surgery 164 S 5th, Montpelier, ID 83254 2007-01-24
1447311139 Bear Lake County Ambulance 385 Cemetary Road, Montpelier, ID 83254 2006-12-13
1073685343 Steven D Hammond Dentist 455 Washington St, Montpelier, ID 83254 2006-11-14
1982610549 Dorian S Grunig Nurse Anesthetist, Certified Registered 164 South 5th, Montpelier, ID 83254 2006-08-01
1104840412 Harold A Olson Pharmacist 765 Washington St., Montpelier, ID 83254 2006-07-27
1265505705 Robert D Degnan Obstetrics & Gynecology 742 Washington St, Montpelier, ID 83254 2006-11-15
1952491714 Gary Scott Griffin Nurse Anesthetist, Certified Registered 164 South 5th, Montpelier, ID 83254 2006-10-13
1013027952 Matthew Brinton Stevens Chiropractor 710 N 4th St, Montpelier, ID 83254-1050 2006-08-30
1265542435 Reset P.a. Chiropractor 710 N 4th St, Montpelier, ID 83254-1050 2006-08-30
1740598614 Bear Lake Memorial Hospital Assisted Living Facility 855 Boise St, Montpelier, ID 83254-1070 2010-09-14
Find all providers in zip 83254

Taxonomy Information

Taxonomy Code 3336C0002X
Grouping Suppliers
Classification Pharmacy
Specialization Clinic Pharmacy

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1184163511 Bear Lake Community Health Center Pharmacy - 340b Pharmacy 152 S 4th St, Montpelier, ID 83254-1538 2017-02-17

Providers in the same taxonomy and state

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
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

Competitor

Search similar providers

City MONTPELIER
Zip Code 83254

Improve Information

Please comment or provide details below to improve the information on BEAR LAKE COMMUNITY HEALTH CENTER.

Dataset Information

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.

Trending Searches