NPIMap

Organization Active NPI

St Lukes Regional Medical Center

Doing business as St Lukes Pharmacy Locker - Eagle Winco

  • Pharmacy
  • Eagle, ID
National Provider Identifier
1013792993
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
ST LUKES REGIONAL MEDICAL CENTER
Doing business as
St Lukes Pharmacy Locker - Eagle Winco
Practice address
3032 E State St
Eagle, ID 83616-6230
Phone
(208) 706-5255
Fax
(208) 706-5253
NPI assigned
Aug 29, 2023
Last updated
Jun 20, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
ST LUKES HEALTH SYSTEM LTDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kelly Curtis
Title
Chief Pharmacy Officer
Phone
(208) 493-2307

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU Primary

Addresses

Primary practice location

3032 E State St
Eagle, ID 83616-6230

Mailing address

190 E Bannock St
Boise, ID 83712-6241
Phone (208) 706-5255

Other names 1

  • ST LUKES PHARMACY LOCKER - EAGLE WINCO Doing business as

National Provider Directory

National Provider Directory
Tax ID family
St Lukes Regional Med Ctr50 organizations share this tax ID, including this one
Part of
St Luke's Children's

Other organizations with this tax ID 49

Organizations that report the same tax identification number in the National Provider Directory.

View all 49

Locations

3032 E State St
Eagle, ID 83616

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1693267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718841600000",
    "number": "1013792993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "208-706-5255",
            "fax_number": "208-706-5254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3032 E STATE ST",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166230",
            "telephone_number": "208-706-5255",
            "fax_number": "208-706-5253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LUKES REGIONAL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST LUKES HEALTH SYSTEM LTD",
        "enumeration_date": "2023-08-29",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A",
        "authorized_official_last_name": "CURTIS",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "CHIEF PHARMACY OFFICER",
        "authorized_official_telephone_number": "208-493-2307"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST LUKES PHARMACY LOCKER - EAGLE WINCO",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ST LUKES PHARMACY LOCKER - EAGLE WINCO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eagle, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.