Heartland Pharmacy

LBN: Heartland Pharmacy - Idaho Falls
Heartland Pharmacy is an health care organization with primary practice located at 3250 E 17Th St , Ammon ID 83406-6758. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Long Term Care Pharmacy is the primary health care specialty. Heartland Pharmacy - Idaho Falls can be contacted via phone (208) 552-7677, or through Ferguson, Andrea via phone (208) 497-3575.

Contact Information

Primary practice address
3250 E 17Th St Ammon ID 83406-6758
Fax: (208) 552-2098
Website:
Authorized official contact:
Name: Ferguson, Andrea

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Long Term Care Pharmacy 3336L0003X 1624LS Idaho

Profile Details

NPI number 1740265420
LBN Legal business name Heartland Pharmacy - Idaho Falls
DBA Doing business as Heartland Pharmacy
Authorized official Ferguson, Andrea
Entity Organization
Organization subpart 1 No
Enumeration date Dec 14th, 2005
Last updated Dec 14th, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740265420 NPPES
Montana MEDICAID 0212857
Montana MEDICAID 1740265420
Montana MEDICAID 806143700
Montana Other 2021757

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