NPIMap

Organization Active NPI

St Lukes Regional Medical Center

Doing business as ST Lukes Elmore Pharmacy

  • Long Term Care Pharmacy
  • MTN Home, ID
National Provider Identifier
1245371863
Registry record updated Mar 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
ST LUKES REGIONAL MEDICAL CENTER
Doing business as
ST Lukes Elmore Pharmacy
Practice address
895 N 6TH E
MTN Home, ID 83647-2207
Phone
(208) 587-8401
Fax
(208) 587-8406
NPI assigned
Feb 8, 2007
Last updated
Mar 30, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
ST LUKE'S REGIONAL MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 30, 2022

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

Authorized official

Name
Mrs. Kelley Curtis
Title
Chief Pharmacy Officer
Phone
(208) 493-2307

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

895 N 6TH E
MTN Home, ID 83647-2207

Mailing address

PO Box 2777
Boise, ID 83701-2777
Phone (208) 493-2307

Other identifiers 1

IdentifierTypeStateIssuer
1302582OtherIDNCPDP NUMBER

Other names 1

  • ST Lukes Elmore Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
St Lukes Regional Med Ctr50 organizations share this tax ID, including this one
Part of
St Lukes Regional Med Ctr

Other organizations with this tax ID 49

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

View all 49

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648598400000",
    "number": "1245371863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2777",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837012777",
            "telephone_number": "208-493-2307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 N 6TH E",
            "city": "MTN HOME",
            "state": "ID",
            "postal_code": "836472207",
            "telephone_number": "208-587-8401",
            "fax_number": "208-587-8406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LUKES REGIONAL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST LUKE'S REGIONAL MEDICAL CENTER",
        "enumeration_date": "2007-02-08",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A",
        "authorized_official_last_name": "CURTIS",
        "authorized_official_first_name": "KELLEY",
        "authorized_official_title_or_position": "CHIEF PHARMACY OFFICER",
        "authorized_official_telephone_number": "208-493-2307",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP NUMBER",
            "identifier": "1302582",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST Lukes Elmore Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ST Lukes Elmore Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in MTN Home, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; 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.