Medicine Man Rathdrum Pharmacy
LBN: Medicine Man West Llc
Medicine Man Rathdrum Pharmacy is an health care organization with primary practice located at 15837 N Westwood Dr , Rathdrum ID 83858-6432. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy, Suppliers / Mail Order Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Medicine Man West Llc can be contacted via phone (208) 687-5717, or through Bell, Duncan via phone (208) 687-5717.
Contact Information
Primary practice address
15837 N Westwood Dr
Rathdrum ID 83858-6432
Phone: (208) 687-5717
Fax: (208) 687-9387
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 1513RP | Idaho |
| Suppliers / Compounding Pharmacy | 3336C0004X | ||
| Suppliers / Mail Order Pharmacy | 3336M0002X |
Profile Details
| NPI number | 1982665923 |
|---|---|
| LBN Legal business name | Medicine Man West Llc |
| DBA Doing business as | Medicine Man Rathdrum Pharmacy |
| Authorized official | Bell, Duncan |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Mar 29th, 2006 |
| Last updated | Jun 26th, 2014 - about 10 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 | 1982665923 | NPPES |
| Other | 2021740 | PK | |
| MEDICAID | 805797600 | PK |
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