Veterans Pharma Incorporated

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

VETERANS PHARMA INCORPORATED

Doing business as

Premium Rx Services

Practice address

9196 W Emerald St
Suite 110
Boise, ID 83704-0679

Phone

(208) 323-1259

Fax

(208) 323-5666

NPI assigned

Jul 1, 2013

Last updated

Sep 25, 2013By 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

Derek Molyneux, PHARMD.

Title

Pharmacy Manager

Phone

(208) 323-1259

Specialties & licenses 1

Addresses

Other names 1

• Premium Rx Services Doing business as

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

{
    "created_epoch": "1372636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380067200000",
    "number": "1346680683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9196 W EMERALD ST",
            "address_2": "SUITE 110",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837040679",
            "telephone_number": "208-323-1259",
            "fax_number": "208-323-5666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9196 W EMERALD ST",
            "address_2": "SUITE 110",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837040679",
            "telephone_number": "208-323-1259",
            "fax_number": "208-323-5666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VETERANS PHARMA INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-01",
        "last_updated": "2013-09-25",
        "status": "A",
        "authorized_official_last_name": "MOLYNEUX",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "208-323-1259",
        "authorized_official_credential": "PHARMD."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premium Rx Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bonita Klahn Vestal, M.D.
• Robert Elden Vestal, M.D.
• Veteran Home Care LLC
• Veteran's Administration Medical Center
• Veterans Adminisatration Medical Center
• Gretchen Vetter, PA
• Vibra Hospital of Boise LLC (Vibra Hospital of Boise)
• Amber M Vickers, PA-C
• Jenny Vickhammer, BCBA
• Cymbria Arielynn Victor

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2013; 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.