Organization Active NPI

Pure Path Compounding Pharmacy LLC

  • Compounding Pharmacy
  • Boise, ID
National Provider Identifier
1033917810
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Compounding PharmacyTaxonomy code 3336C0004X
Legal business name
PURE PATH COMPOUNDING PHARMACY LLC
Practice address
2141 W Airport Way Ste 700
Boise, ID 83705-5168
Phone
(208) 985-3575
NPI assigned
Mar 6, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

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

Authorized official

Name
Kevin Crumley
Title
Operations Manager
Phone
(208) 985-3575

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Compounding Pharmacy 3336C0004X Primary
Home Infusion Therapy Pharmacy 3336H0001X
Mail Order Pharmacy 3336M0002X
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

2141 W Airport Way Ste 700
Boise, ID 83705-5168

Mailing address

2141 W Airport Way Ste 700
Boise, ID 83705-5168

National Provider Directory

National Provider Directory

Locations

2141 W Airport Way
Ste 700
Boise, ID 83705
Phone (208) 985-3575

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1741219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742774400000",
    "number": "1033917810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2141 W AIRPORT WAY STE 700",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837055168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2141 W AIRPORT WAY STE 700",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837055168",
            "telephone_number": "208-985-3575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURE PATH COMPOUNDING PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-06",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A",
        "authorized_official_last_name": "CRUMLEY",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "208-985-3575"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Mar 24, 2025; 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.