NPIMap

Organization Active NPI

Pharmacy Shop Inc

  • Pharmacy
  • Pocatello, ID
National Provider Identifier
1295897171
Registry record updated Jun 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
801CP Issued in ID
Legal business name
PHARMACY SHOP INC
Practice address
1015 E Young
Pocatello, ID 83201
Phone
(208) 232-0049
Fax
(208) 232-3963
NPI assigned
Dec 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2008

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

Authorized official

Name
Mr. Edward L Snell, RPH CCN
Title
President
Phone
(208) 232-0049

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 801CP ID Primary

Addresses

Primary practice location

1015 E Young
Pocatello, ID 83201

Mailing address

1015 E Young
Pocatello, ID 83201
Phone (208) 232-0049

Other identifiers 3

IdentifierTypeStateIssuer
002631400OtherIDMEDICAID
002631600MedicaidID
8C451OtherIDPRIVATE INS BLUE CROSS

Other names 1

  • Ed Snells Pharmacy Shop Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212710400000",
    "number": "1295897171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 E YOUNG",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "83201",
            "telephone_number": "208-232-0049",
            "fax_number": "208-232-3963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 E YOUNG",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "83201",
            "telephone_number": "208-232-0049",
            "fax_number": "208-232-3963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMACY SHOP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2008-06-06",
        "status": "A",
        "authorized_official_last_name": "SNELL",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-232-0049",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH CCN"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "ID",
            "license": "801CP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "002631400",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002631600",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE INS BLUE CROSS",
            "identifier": "8C451",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ed Snells Pharmacy Shop",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2008; 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.