NPIMap

Organization Active NPI

Deblaquiere Enterprises, Inc.

  • Community/Retail Pharmacy
  • Priest River, ID
National Provider Identifier
1285621136
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
DEBLAQUIERE ENTERPRISES, INC.
Practice address
5453 Highway 2
Priest River, ID 83856
Phone
(208) 448-1633
Fax
(208) 448-1728
NPI assigned
Oct 4, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Shannon McGlashan
Title
Corp. Secretary
Phone
(208) 448-1633

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

5453 Highway 2
Priest River, ID 83856

Mailing address

PO Box 458
Priest River, ID 83856-0458
Phone (208) 448-1633

Other identifiers 2

IdentifierTypeStateIssuer
002464600MedicaidID
002464700MedicaidID

Other names 1

  • White Cross Pharmacy Priest River Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930049573 ID DME Supplier - PharmacyDME Supplier - Orthotic PersonnelDME Supplier - Prosthetic Personnel 8820202765 Practice locations: Priest River, ID
O20101013000584 ID Part B Supplier - Mass Immunization (Roster Biller Only) 8820202765 3 other NPIs on this enrollment
Practice locations: Oldtown, ID; Priest River, ID; Sandpoint, ID; Spirit Lake, ID

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
13D1045240White Cross Pharmacy - Priest River5453 Highway 2, Priest River, ID 83856Certificate of waiverSep 8, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Deblaquiere Enterprises Inc5453 Highway 2, Priest River, ID 83856-0458(208) 448-1633 Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Canes and/or Crutches|Walkers|Ostomy Supplies|Urological Supplies|Enteral Nutrients|Enteral Equipment and/or Supplies|Nebulizer Equipment and/or Supplies|Surgical Dressings|Diabetic Shoes and Inserts Does not accept assignmentParticipating since Jul 16, 2002

National Provider Directory

National Provider Directory
Tax ID family
Deblaquiere Enterprises Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Practitioners & affiliated clinicians

Practitioners 9

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": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1285621136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 458",
            "city": "PRIEST RIVER",
            "state": "ID",
            "postal_code": "838560458",
            "telephone_number": "208-448-1633",
            "fax_number": "208-448-1728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5453 HIGHWAY 2",
            "city": "PRIEST RIVER",
            "state": "ID",
            "postal_code": "83856",
            "telephone_number": "208-448-1633",
            "fax_number": "208-448-1728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBLAQUIERE ENTERPRISES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-04",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "MCGLASHAN",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "CORP. SECRETARY",
        "authorized_official_telephone_number": "208-448-1633"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002464600",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002464700",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "White Cross Pharmacy Priest River",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "White Cross Pharmacy Priest River",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Priest River, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.