Active NPI
Pure Path Compounding Pharmacy LLC
- Compounding Pharmacy
- Boise, ID
National Provider Identifier
1033917810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Compounding Pharmacy
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 DirectoryLocations
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.
-
- Clinical Pharmacology Physician
- Boise, ID
- NPI 1093504086
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.