Active NPI
Thrifty Payless Inc
- Community/Retail Pharmacy
- Coeur D Alene, ID
National Provider Identifier
1053420596
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- ID1219CP
- Legal business name
- THRIFTY PAYLESS INC
- Practice address
- 208 West Ironwood Drive
Ironwood Square
Coeur D Alene, ID 83814-2640 - Phone
- (208) 664-3185
- NPI assigned
- Aug 29, 2006
- 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
- Jennifer Zorek
- Title
- Director
- Phone
- (717) 975-5937
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | |||
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Community/Retail Pharmacy | 3336C0003X | ID1219CP | ID | Primary |
Addresses
Primary practice location
208 West Ironwood Drive
Ironwood Square
Coeur D Alene, ID 83814-2640
Mailing address
200 Newberry Commons
Etters, PA 17319-9363
Phone (717) 761-2633
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1305487 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER | |
| 804029100 | Medicaid | ID |
Other names 1
- RITE AID PHARMACY 05420
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090917000352 | ID | Part B Supplier - Mass Immunization (Roster Biller Only) | 7719979095 |
14 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Moscow, ID; Meridian, ID; McCall, ID; Lewiston, ID; Hayden, ID; Coeur D' Alene, ID; Boise, ID; Caldwell, ID |
Other NPIs on the same Medicare enrollment 14
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1680566400000",
"number": "1053420596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 NEWBERRY COMMONS",
"city": "ETTERS",
"state": "PA",
"postal_code": "173199363",
"telephone_number": "717-761-2633",
"fax_number": "717-975-8659"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "208 WEST IRONWOOD DRIVE",
"address_2": "IRONWOOD SQUARE",
"city": "COEUR D ALENE",
"state": "ID",
"postal_code": "838142640",
"telephone_number": "208-664-3185"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THRIFTY PAYLESS INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-29",
"last_updated": "2023-04-04",
"certification_date": "2023-04-04",
"status": "A",
"authorized_official_last_name": "ZOREK",
"authorized_official_first_name": "JENNIFER",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "717-975-5937"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": false
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "ID",
"license": "ID1219CP",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "1305487",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "804029100",
"state": "ID"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "RITE AID PHARMACY 05420",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "RITE AID PHARMACY 05420",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Coeur D Alene, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.