Organization · Type 2 NPI

Sandpoint Super Drug Clinical

Family Medicine Physician · Sandpoint, ID

NPI number 1104584739 Active

Practice location

604 N Fifth Ave
Sandpoint, ID 83864-1520

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician Primary	207Q00000X	None listed
Clinic Pharmacy	3336C0002X	None listed

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

2 other providers at this address

Other family medicine physician providers in Sandpoint

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NPI record

NPI: 1104584739
Entity type: Organization (Type 2)
Issued: Dec 1, 2021
Last updated: Mar 24, 2022
Status: Active

Other names

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Sandpoint Super Drug Clinical Services · other name
Sandpoint Super Drug Clinical Services · other name

Authorized official

Scott Porter, PharmD
Authorized Official
(208) 263-1408

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1104584739

Sandpoint Super Drug Clinical's National Provider Identifier is 1104584739, issued on Dec 1, 2021. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Sandpoint, ID. The record was last updated on Mar 24, 2022.