Latah Health Pharmacy
LBN: Latah Community Health Pharmacy
Latah Health Pharmacy is an health care organization with primary practice located at 803 S Main St Ste 120 , Moscow ID 83843-3043. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Clinic Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Clinic Pharmacy is the primary health care specialty.
Latah Community Health Pharmacy can be contacted via phone (208) 848-8312, or through Wilson, Aaron via phone (509) 444-8888.
Contact Information
Primary practice address
803 S Main St Ste 120
Moscow ID 83843-3043
Phone: (208) 848-8312
Fax: (208) 882-5587
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Suppliers / Pharmacy | 333600000X | ||
Suppliers / Clinic Pharmacy | 3336C0002X | 37042RP | Idaho |
Suppliers / Community/Retail Pharmacy | 3336C0003X |
Profile Details
NPI number | 1750786356 |
---|---|
LBN Legal business name | Latah Community Health Pharmacy |
DBA Doing business as | Latah Health Pharmacy |
Authorized official | Wilson, Aaron |
Entity | Organization |
Organization subpart 1 | No |
Enumeration date | Oct 27th, 2014 |
Last updated | Aug 21st, 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1750786356 | NPPES |
Idaho | MEDICAID | 1750786356 | |
Idaho | Other | 2148393 | |
Idaho | MEDICAID | 2073987 |
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