Organization · Type 2 NPI

Idaho State University

Community/Retail Pharmacy · Chubbuck, ID

NPI number 1740964295 Active

Practice location

4914 Yellowstone Ave Ste A
Chubbuck, ID 83202-2332

Call (208) 282-5790 Map

Fax (208) 237-3906

Mailing address

990 S 8th Ave Stop 8158
Pocatello, ID 83201-4982

Specialties and licenses

Taxonomy	Code	License
Community/Retail Pharmacy Primary	3336C0003X	None listed

Community/Retail Pharmacy: A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other …

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NPI record

NPI: 1740964295
Entity type: Organization (Type 2)
Issued: Jun 14, 2023
Last updated: May 15, 2024
Status: Active

Other names

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Isu Bengal Pharmacy Chubbuck · other name
Isu Bengal Pharmacy Chubbuck · other name

Authorized official

Cynthia Lee Rock
Clinics Director of Operations
(208) 373-1743

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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 1740964295

Idaho State University's National Provider Identifier is 1740964295, issued on Jun 14, 2023. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Chubbuck, ID. The record was last updated on May 15, 2024.