Interlake Pharmacy Inc
LBN: Interlake Pharmacy Inc
Interlake Pharmacy Inc is an health care organization with primary practice located at 700 W Ironwood Dr Suite 159, Coeur D Alene ID 83814-2656. The organization recently has 2 registered licenses in different health care specialties including Pharmacy Service Providers / Pharmacist, Suppliers / Durable Medical Equipment & Medical Supplies. Pharmacy Service Providers / Pharmacist is the primary health care specialty.
Interlake Pharmacy Inc can be contacted via phone (208) 664-6664, or through Brown, Tim via phone (208) 664-6664.
Contact Information
Primary practice address
700 W Ironwood Dr Suite 159
Coeur D Alene ID 83814-2656
Phone: (208) 664-6664
Fax: (208) 664-8527
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Pharmacy Service Providers / Pharmacist | 183500000X | 782CP | Idaho |
Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | 782CP | Idaho |
Profile Details
NPI number | 1467425249 |
---|---|
LBN Legal business name | Interlake Pharmacy Inc |
DBA Doing business as | |
Authorized official | Brown, Tim RPH |
Entity | Organization |
Organization subpart 1 | No |
Enumeration date | Feb 10th, 2006 |
Last updated | Sep 14th, 2015 - about 9 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1467425249 | NPPES |
Idaho | MEDICAID | 002627900 | |
Idaho | MEDICAID | 001679200 |
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