Home Living Services Inc
Organization Active NPI Pharmacy · Pocatello, ID
NPI 1023004348 · NPPES record last updated Aug 10, 2009
Key facts
- NPI
- 1023004348
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- 1319LS (ID)
- Legal business name
- HOME LIVING SERVICES INC
- Practice address
- 436 E Bonneville St
Pocatello, ID 83201-6406 - Phone
- (208) 233-3466
- Fax
- (208) 234-9686
- NPI assigned
- Sep 22, 2005
- Organization subpart
- No
Authorized official
- Name
- Mr. Tori Daniel Shaver
- Title
- Owner
- Phone
- (208) 232-9392
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 1319LS | ID | Yes |
| Long Term Care Pharmacy | 3336L0003X | 1319LS | ID |
Addresses
Primary practice location
436 E Bonneville St
Pocatello, ID 83201-6406
Mailing address
436 E Bonneville St
Pocatello, ID 83201-6406
Phone (208) 233-3466
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002721800 | Medicaid | ID |
Other providers in Pocatello, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2009. 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.