Organization Active NPI

Lukes Family Pharmacy LLC

  • Durable Medical Equipment & Medical Supplies
  • Hailey, ID
National Provider Identifier
1083985766
Registry record updated Oct 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
LUKES FAMILY PHARMACY LLC
Practice address
101 S Main St
Hailey, ID 83333-8408
Phone
(208) 788-4970
Fax
(208) 788-5791
NPI assigned
Jan 26, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2012

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

Authorized official

Name
Mr. Lucas Roy Snell
Title
Pharmacist/Owner
Phone
(208) 788-4970

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X ID Primary

Addresses

Primary practice location

101 S Main St
Hailey, ID 83333-8408

Mailing address

101 S Main St
Hailey, ID 83333-8408
Phone (208) 788-4970

Other names 1

  • LUKES FAMILY PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120828000418 ID Part B Supplier - Mass Immunization (Roster Biller Only) 8527221712 Practice locations: Hailey, ID

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1327536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350604800000",
    "number": "1083985766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S MAIN ST",
            "city": "HAILEY",
            "state": "ID",
            "postal_code": "833338408",
            "telephone_number": "208-788-4970",
            "fax_number": "208-788-5791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S MAIN ST",
            "city": "HAILEY",
            "state": "ID",
            "postal_code": "833338408",
            "telephone_number": "208-788-4970",
            "fax_number": "208-788-5791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUKES FAMILY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-26",
        "last_updated": "2012-10-19",
        "status": "A",
        "authorized_official_last_name": "SNELL",
        "authorized_official_first_name": "LUCAS",
        "authorized_official_middle_name": "ROY",
        "authorized_official_title_or_position": "PHARMACIST/OWNER",
        "authorized_official_telephone_number": "208-788-4970",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LUKES FAMILY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hailey, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2012; 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.

Verify at the official NPI Registry.