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institution
Idaho State University
Health Service Clinic/Center in Chubbuck, Idaho
NPI 1457060790

Idaho State University is a Health Service Clinic/Center based in Pocatello, ID and is specialized in Health Service. Idaho State University practices in Chubbuck, ID. The NPI Number for Idaho State University is 1457060790 and holds a License No. (Idaho).

The current practice location address for Idaho State University is 4914 Yellowstone Ave Ste B, Chubbuck, ID and can be reached out via phone at 208-282-2005.

Location: 4914 Yellowstone Ave Ste B, Chubbuck, ID, 83201-4982
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1457060790
Provider Name
Idaho State University
Credential
Provider Entity Type
Organization
Address
4914 Yellowstone Ave Ste B, Chubbuck, ID, 83201-4982
Phone Number
208-282-2005
Fax Number
Provider Enumeration Date
11/15/2022
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
4914 Yellowstone Ave Ste B
City
Chubbuck
State
Idaho
Zip
83202-2332
Phone Number
208-282-2005
Fax Number
person
Provider Business Mailing Address Details
Address
4914 Yellowstone Ave Ste B
City
Chubbuck
State
Idaho
Zip
83202-2332
Phone Number
208-282-2005
Fax Number
person
Provider's Taxonomy Details 1
Type
Pharmacy Service Providers
Classification
Pharmacist
Speciality
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Taxonomy
1835P0018X
License No.
()
Definition
Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management.
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Health Service
Taxonomy
261QH0100X
License No.
()
Definition
Definition to come...
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