Fogg Drug Co Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

214RP Issued in ID

Legal business name

FOGG DRUG CO INC

Doing business as

Hyway Drug

Practice address

120 Northgate Mile
Idaho Falls, ID 83401-2543

Phone

(208) 522-8357

Fax

(208) 528-0288

NPI assigned

Jan 30, 2007

Organization subpart

No

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

Authorized official

Name

Stephen Fogg, RPH

Title

Manager

Phone

(208) 522-8357

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• HYWAY DRUG Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419206400000",
    "number": "1205972817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 NORTHGATE MILE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834012543",
            "telephone_number": "208-522-8357",
            "fax_number": "208-528-0288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 NORTHGATE MILE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834012543",
            "telephone_number": "208-522-8357",
            "fax_number": "208-528-0288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOGG DRUG CO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2014-12-22",
        "status": "A",
        "authorized_official_last_name": "FOGG",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "208-522-8357",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "ID",
            "license": "214RP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2020088",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002291200",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HYWAY DRUG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Angela M Fletcher, LCPC
• Jalynne Fletcher, LPC
• Flint R Packer DO PC
• Flower Aston Nutrition LLC
• Stephen J. Focht, M.D.
• Alyssa Folker, M.S.
• Shelley Jo Folsom, WHNP-BC
• Austin Michal Fontes, LMSW
• Food Freedom Nutrition, LLC
• Foot & Ankle Specialists of Idaho, P.C.

• Community/Retail Pharmacy in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Community/Retail Pharmacy in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2014; 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.