Kootenai Clinics Cancer Services Pharmacy

LBN: Kootenai Health, Inc.
Kootenai Clinics Cancer Services Pharmacy is an health care organization with primary practice located at 700 W Ironwood Dr , Coeur D Alene ID 83814-2656. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Clinic Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Clinic Pharmacy is the primary health care specialty. Kootenai Health, Inc. can be contacted via phone (208) 625-5670, or through Ness, Jon via phone (208) 625-5081.

Contact Information

Primary practice address
700 W Ironwood Dr Coeur D Alene ID 83814-2656
Fax: (208) 625-5669
Website:
Authorized official contact:
Name: Ness, Jon

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Clinic Pharmacy 3336C0002X 1198LS Idaho
Suppliers / Specialty Pharmacy 3336S0011X

Profile Details

NPI number 1073835591
LBN Legal business name Kootenai Health, Inc.
DBA Doing business as Kootenai Clinics Cancer Services Pharmacy
Authorized official Ness, Jon
Entity Organization
Organization subpart 1 No
Enumeration date Feb 25th, 2010
Last updated Jan 5th, 2024 - about 8 months 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 1073835591 NPPES
Idaho MEDICAID 1073835591
Idaho Other 2124398

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