Bonner Professional Compounding
Organization Active NPI Compounding Pharmacy · Sandpoint, ID
NPI 1154532794 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1154532794
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Compounding Pharmacy 3336C0004X
- License
- 1402CP (ID)
- Legal business name
- BONNER PROFESSIONAL COMPOUNDING
- Practice address
- 520 N 3Rd Ave
Sandpoint, ID 83864-1507 - Phone
- (208) 265-1093
- Fax
- (208) 265-1031
- NPI assigned
- May 25, 2007
- Organization subpart
- No
Authorized official
- Name
- Ms. Mary F. Snider, RPH
- Title
- Pharmacist in Charge
- Phone
- (208) 265-1093
Corporate family (same tax ID) 8
National Provider Directory
- Tax ID family
- Bonner General Hospital Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Compounding Pharmacy | 3336C0004X | 1402CP | ID | Yes |
Addresses
Primary practice location
520 N 3Rd Ave
Sandpoint, ID 83864-1507
Mailing address
520 N 3Rd Ave
Sandpoint, ID 83864-1507
Phone (208) 265-1093
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1402CP | Other | ID | STATE LICENSE # |
| 1306718 | Other | ID | NCPDS # |
Other providers in Sandpoint, ID
- Bonner General Hospital, Inc.
- Bonner General Hospital, Inc.
- Bonner Partners in Care Clinic
- Bonner Physical Therapy P.C.
- Bonner Professional Compounding
- Laura Bonneville
- Dawn Borkowski
- Patsy Botoms
- Lou Ann Bottomly
- Boundary Regional Community Health Center Inc
All providers in Sandpoint, ID · Compounding Pharmacy in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.