NPIMap

Organization Active NPI

St Luke'S Reg Med Ctr Employee Outpt Pharmacy

  • Pharmacy
  • Boise, ID
National Provider Identifier
1023010642
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
1019CP Issued in ID
Legal business name
ST LUKE'S REG MED CTR EMPLOYEE OUTPT PHARMACY
Practice address
190 E Bannock St
Boise, ID 83712-6241
Phone
(208) 381-4353
Fax
(208) 381-4355
NPI assigned
Aug 12, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
James W Normark, RPH
Title
Operation Manager, Outpt Pharmacy
Phone
(208) 381-4354

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 1019CP ID Primary

Addresses

Primary practice location

190 E Bannock St
Boise, ID 83712-6241

Mailing address

190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-4353

Other identifiers 2

IdentifierTypeStateIssuer
1019CPOtherIDPHARMACY LICENSE
1305653OtherNABP

Other names 1

  • St Luke's EOP Other name

National Provider Directory

National Provider Directory
Tax ID family
Richard H Lane MD50 organizations share this tax ID, including this one

Other organizations with this tax ID 49

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

View all 49

NPI Registry JSON

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023010642",
    "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": "208-381-4353",
            "fax_number": "208-381-4355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "208-381-4353",
            "fax_number": "208-381-4355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LUKE'S REG MED CTR EMPLOYEE OUTPT PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NORMARK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OPERATION MANAGER, OUTPT PHARMACY",
        "authorized_official_telephone_number": "208-381-4354",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "ID",
            "license": "1019CP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE",
            "identifier": "1019CP",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "1305653",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Luke's EOP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.