NPIMap

Organization Active NPI

Teton Clinical Pharmacy, Inc.

  • Community/Retail Pharmacy
  • Idaho Falls, ID
National Provider Identifier
1043629397
Registry record updated May 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
TETON CLINICAL PHARMACY, INC.
Practice address
1855 W Broadway St
Idaho Falls, ID 83402-3043
Phone
(208) 529-3638
Fax
(208) 529-1715
NPI assigned
Aug 11, 2014
Organization subpart
Yes
Parent organization
TETON CLINICAL PHARMACY, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 3, 2019

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

Authorized official

Name
Dr. Philip Harper, DMD
Title
Owner
Phone
(208) 360-1317

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

1855 W Broadway St
Idaho Falls, ID 83402-3043

Mailing address

1855 W Broadway St
Idaho Falls, ID 83402-3043
Phone (208) 529-3638

Other names 1

  • Teton Pharmacy On Broadway Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Teton Clinical Pharmacy Inc2 organizations share this tax ID, including this one
Part of
Teton Clinical Pharmacy Inc

Other organizations with this tax ID 1

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

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": "1407715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556841600000",
    "number": "1043629397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 W BROADWAY ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023043",
            "telephone_number": "208-529-3638",
            "fax_number": "208-529-1715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 W BROADWAY ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023043",
            "telephone_number": "208-529-3638",
            "fax_number": "208-529-1715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TETON CLINICAL PHARMACY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TETON CLINICAL PHARMACY, INC.",
        "enumeration_date": "2014-08-11",
        "last_updated": "2019-05-03",
        "status": "A",
        "authorized_official_last_name": "HARPER",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-360-1317",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Teton Pharmacy On Broadway",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Teton Pharmacy On Broadway",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2019; 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.