NPIMap

Organization Active NPI

Inclusive Care LLC

  • Clinic Pharmacy
  • Chubbuck, ID
National Provider Identifier
1235900424
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
Legal business name
INCLUSIVE CARE LLC
Practice address
407 E Chubbuck Rd
Chubbuck, ID 83202
Phone
(208) 913-2273
Fax
(208) 567-5615
NPI assigned
Jan 16, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Authorized official

Name
Dr. Alexandra Louise Heyneman, PHARMDNPI 1396473096
Title
Owner
Phone
(208) 913-2273

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X Primary

Addresses

Primary practice location

407 E Chubbuck Rd
Chubbuck, ID 83202

Mailing address

PO Box 2851
Pocatello, ID 83206-2851

Other names 1

  • Inclusive Care Clinic Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240917000360 ID Part B Supplier - Pharmacy 2961943055 Practice locations: Chubbuck, ID

National Provider Directory

National Provider Directory
Tax ID family
Inclusive Care Clinic Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

407 E Chubbuck Rd
Pocatello, ID 83202
Phone (208) 913-2273

Practitioners & affiliated clinicians

Practitioners 3

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": "1705363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1235900424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2851",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832062851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 E CHUBBUCK RD",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "83202",
            "telephone_number": "208-913-2273",
            "fax_number": "208-567-5615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INCLUSIVE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-16",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "HEYNEMAN",
        "authorized_official_first_name": "ALEXANDRA",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-913-2273",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Inclusive Care Clinic Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Inclusive Care Clinic Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chubbuck, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; 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.