Emalie Bumgardner, PHARM.D.

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

I58719 Issued in ID

Practice address

583 Commerce Drive
Smelterville, ID 83868-0000

Phone

(208) 783-2739

NPI assigned

Aug 14, 2024

Last updated

Aug 14, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Walmart Inc.

  • Community/Retail Pharmacy
  • Smelterville, ID
  • NPI 1740345859
  NPD (past)
• Walmart Inc.

  dba Walmart Pharmacy 10-3129

  • Community/Retail Pharmacy
  • Eastvale, CA
  • NPI 1770458945
  NPD (past)

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

{
    "created_epoch": "1723593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1225860885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1063",
            "city": "PINEHURST",
            "state": "ID",
            "postal_code": "838501063",
            "telephone_number": "208-512-5693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "583 COMMERCE DRIVE",
            "city": "SMELTERVILLE",
            "state": "ID",
            "postal_code": "838680000",
            "telephone_number": "208-783-2739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUMGARDNER",
        "first_name": "EMALIE",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-14",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "ID",
            "license": "I58719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Boyd Arthurs, RPH
• Bandz, Inc.
• Austin Carpenter
• Crystal Ann Cheromiah, LCSW
• Jessica Ann Harnisch-Boyd, DO, MPH
• Isaac Jisung Lee
• Ann N Moffett, NP-C

• Student in an Organized Health Care Education/Training Program in Smelterville, ID
• Providers in Smelterville, ID by specialty
• Student in an Organized Health Care Education/Training Program in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; 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.