Medical Clinic Pharmacy
LBN: Medical Clinic Pharmacy Inc
Medical Clinic Pharmacy is an health care organization with primary practice located at 315 E Elm St Suite150, Caldwell ID 83605-4857. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Medical Clinic Pharmacy Inc can be contacted via phone (208) 459-1503, or through Higgins, Tyler via phone (208) 459-1503.
Contact Information
Primary practice address
315 E Elm St Suite150
Caldwell ID 83605-4857
Phone: (208) 459-1503
Fax: (208) 459-1504
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 2373RP | Idaho |
| Suppliers / Compounding Pharmacy | 3336C0004X |
Profile Details
| NPI number | 1962581652 |
|---|---|
| LBN Legal business name | Medical Clinic Pharmacy Inc |
| DBA Doing business as | Medical Clinic Pharmacy |
| Authorized official | Higgins, Tyler |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 3rd, 2006 |
| Last updated | Jul 19th, 2018 - about 6 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 | 1962581652 | NPPES |
| Idaho | MEDICAID | 1962581652 | |
| Idaho | Other | 2123594 |
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