John A Anderson, RPH
Individual provider Active NPI Pharmacist · Nampa, ID
NPI 1003244229 · NPPES record last updated Oct 25, 2013
Key facts
- NPI
- 1003244229
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- P3948 (ID)
- Practice address
- 523 11TH Ave N
Nampa, ID 83687-3442 - Phone
- (208) 466-2431
- Fax
- (208) 466-2439
- NPI assigned
- Oct 25, 2013
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P3948 | ID | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Johns Medic Pharmacy | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | P3948 | ID | Yes |
Addresses
Primary practice location
523 11TH Ave N
Nampa, ID 83687-3442
Mailing address
523 11TH Ave N
Nampa, ID 83687-3442
Phone (208) 466-2431
Other names
- John A Anderson
Other providers in Nampa, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 25, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.