Vics Family Pharmacy Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

800CP Issued in ID

Legal business name

VICS FAMILY PHARMACY INC

Practice address

1513 12TH Ave Rd
Nampa, ID 83686-6008

Phone

(208) 465-7000

Fax

(208) 465-7091

NPI assigned

Oct 12, 2005

Last updated

Jan 15, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Victor F Allen, BPHNPI 1700143872

Title

Owner Pharmacist in Charge

Phone

(208) 465-7000

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in ID2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Vics Family Pharmacy Inc

  • Pharmacy
  • Nampa, ID
  • NPI 1861780330

  0143347096

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Vics Family Pharmacy Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Vic's Family Pharmacy Inc

  • Pharmacy
  • Kuna, ID
  • NPI 1669460093
  NPD tax ID
• Vic's Family Pharmacy Inc

  • Long Term Care Pharmacy
  • Nampa, ID
  • NPI 1740879097
  NPD tax ID
• Vics Family Pharmacy Inc

  • Pharmacy
  • Nampa, ID
  • NPI 1861780330
  NPD tax ID

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Victor F Allen, R.PH.

  • Pharmacist
  • Nampa, ID
  • NPI 1700143872
  NPD (past) Authorized official
• Jennifer Roe, PHARMD

  • Pharmacist
  • Nampa, ID
  • NPI 1306214275
  NPD (past)
• Kaitlin Ann Rourk, PHARMD

  • Pharmacist
  • Boise, ID
  • NPI 1063187029
  NPD (past)

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547510400000",
    "number": "1255329405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1513 12TH AVE RD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866008",
            "telephone_number": "208-465-7000",
            "fax_number": "208-465-7091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1513 12TH AVE RD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866008",
            "telephone_number": "208-465-7000",
            "fax_number": "208-465-7091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICS FAMILY PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-12",
        "last_updated": "2019-01-15",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "208-465-7000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "ID",
            "license": "800CP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "1304790",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "800CP",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "804169900",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christian P Vetsch, MD
• William H. Vetter, M.D.
• Vic's Family Pharmacy Inc
• Lara Leigh Vick-Erickson, LCPC
• Taylor Vickers, PA-C
• Vics Family Pharmacy Inc
• Victory Charter School
• Julie Velasco Villarica
• Michael Vincen-Brown, PA-C
• Laura Marie Vincent, M.S. CCC-SLP

• Pharmacy in Nampa, ID
• Providers in Nampa, ID by specialty
• Pharmacy in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.