NPIMap

Organization Active NPI

Michael D Merrill

Doing business as Mikes Pharmacy

  • Community/Retail Pharmacy
  • Idaho Falls, ID
National Provider Identifier
1285762542
Registry record updated Nov 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
703RP Issued in ID
Legal business name
MICHAEL D MERRILL
Doing business as
Mikes Pharmacy
Practice address
180 S Holmes Ave
Idaho Falls, ID 83401-3945
Phone
(208) 525-8700
Fax
(208) 525-8636
NPI assigned
Mar 1, 2007
Last updated
Nov 10, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2016

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

Authorized official

Name
Michael Merrill, RPHNPI 1558752519
Title
Owner
Phone
(208) 525-8700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 703RP ID Primary

Addresses

Primary practice location

180 S Holmes Ave
Idaho Falls, ID 83401-3945

Mailing address

180 S Holmes Ave
Idaho Falls, ID 83401-3945
Phone (208) 525-8700

Other identifiers 2

IdentifierTypeStateIssuer
002583900MedicaidID
2020589OtherPK

Other names 1

  • MIKES PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Michael D Merrill2 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.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478736000000",
    "number": "1285762542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 S HOLMES AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834013945",
            "telephone_number": "208-525-8700",
            "fax_number": "208-525-8636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 S HOLMES AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834013945",
            "telephone_number": "208-525-8700",
            "fax_number": "208-525-8636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL D MERRILL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2016-11-10",
        "status": "A",
        "authorized_official_last_name": "MERRILL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-525-8700",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "ID",
            "license": "703RP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002583900",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2020589",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MIKES PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2016; 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.