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State Of Idaho
Long Term Care Pharmacy in Blackfoot, Idaho
NPI 1750442315

State Of Idaho is a Long Term Care Pharmacy based in Blackfoot, ID and is specialized in Long Term Care Pharmacy. State Of Idaho practices in Blackfoot, ID. The NPI Number for State Of Idaho is 1750442315 and holds a License No. 462HP (Idaho).

The current practice location address for State Of Idaho is 700 East Alice Street, Blackfoot, ID and can be reached out via phone at 208-785-1200 and via fax at 208-785-8424.

Location: 700 East Alice Street, Blackfoot, ID, 83221
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1750442315
Provider Name
State Of Idaho
Credential
Provider Entity Type
Organization
Address
700 East Alice Street, Blackfoot, ID, 83221
Phone Number
208-785-1200
Fax Number
208-785-8424
Provider Enumeration Date
12/13/2006
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
002825500 05 ID
002835700 05 ID
1302772 01 ID NABP & NCPDP
institution
Provider Business Practice Location Address Details
Address
700 East Alice Street
City
Blackfoot
State
Idaho
Zip
83221
Phone Number
208-785-1200
Fax Number
208-785-8424
person
Provider Business Mailing Address Details
Address
700 East Alice Street
City
Blackfoot
State
Idaho
Zip
83221
Phone Number
208-785-1200
Fax Number
208-785-8424
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Pharmacy
Speciality
-
Taxonomy
333600000X
License No.
462HP (Idaho)
Definition
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.
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Pharmacy
Speciality
Long Term Care Pharmacy
Taxonomy
3336L0003X
License No.
462HP (Idaho)
Definition
A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.
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