Heartland Pharmacy - Boise, NPI 1710056445
Long Term Care Pharmacy in Boise, ID, US

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NPI number: what is it?

The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...

NPI 1710056445
NPI Entity Type Organization
Provider Name Heartland Pharmacy - Boise
Doing Business As
Enumeration Date September 30, 2009
Last Update Date September 30, 2009
Certification Date September 30, 2009
Provider Location Address 8455 W Emerald St, Boise, ID, US
Provider Mailing Address 1790 Sabin Dr, Ammon, ID, US, 834066747
Gender Male
Is Sole Proprietor? No
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Organization Official

Official Name Andrea Ferguson
Official Position EXECUTIVE ASSISTANT
Phone 208-497-3575

Primary Taxonomy

Taxonomy Code

3336L0003X

Taxonomy Name Long Term Care Pharmacy
Classification

Pharmacy

Group

Suppliers

License No. 1679LS
License State ID
Description A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.

Other Organization Name

HEARTLAND LTC PHARMACY
Doing Business As

Business Address

Heartland Pharmacy - Boise
8455 W Emerald St

Boise, ID, US

Phone: 208-323-0067
Fax: 208-323-5954

Mailing Address

Heartland Pharmacy - Boise
1790 Sabin Dr
Ammon, ID, US
ZIP 834066747
Phone: 208-497-3575
Fax: 208-552-2103

Secondary Taxonomies

Taxonomy Code Group Classification License No. State Primary?

333600000X

Suppliers

Pharmacy

No

Other Identifiers

Identifier Identifier State Identifier Issuer Type/Code
805127900 ID MEDICAID 05
2021934 PK 01

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