NPIMap

Organization Active NPI

Rite Aid

  • Community/Retail Pharmacy
  • Idaho Falls, ID
National Provider Identifier
1366630436
Registry record updated Oct 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
P6096 Issued in ID
Legal business name
RITE AID
Practice address
1745 W Broadway St
Idaho Falls, ID 83402-3045
Phone
(208) 524-4480
NPI assigned
Oct 13, 2007
Last updated
Oct 13, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2007

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

Authorized official

Name
John Ryan Bronsell, PHARMD
Title
Staff Pharmacist
Phone
(208) 524-4480

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X P6096 ID Primary

Addresses

Primary practice location

1745 W Broadway St
Idaho Falls, ID 83402-3045

Mailing address

1745 W Broadway St
Idaho Falls, ID 83402-3045

National Provider Directory

National Provider Directory
Tax ID family
James Stephen49 organizations share this tax ID, including this one

Other organizations with this tax ID 48

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

View all 48

Locations

1745 W Broadway St
Idaho Falls, ID 83402
Phone (208) 524-4480

NPI Registry JSON

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

{
    "created_epoch": "1192233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192233600000",
    "number": "1366630436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1745 W BROADWAY ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1745 W BROADWAY ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023045",
            "telephone_number": "208-524-4480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RITE AID",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-13",
        "last_updated": "2007-10-13",
        "status": "A",
        "authorized_official_last_name": "BRONSELL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "STAFF PHARMACIST",
        "authorized_official_telephone_number": "208-524-4480",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "ID",
            "license": "P6096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 13, 2007; 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.