Irwin Drug Inc.

Primary specialty

PharmacyTaxonomy code 333600000X

License

2081CP Issued in ID

Legal business name

IRWIN DRUG INC.

Practice address

146 W Main St
Grangeville, ID 83530-1932

Phone

(208) 983-1090

NPI assigned

Jan 22, 2008

Last updated

May 7, 2008By 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

Mr. Chad Guy JungertNPI 1669427571

Title

President/Owner

Phone

(208) 983-1090

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ID2 enrollments

Enrollment records 2

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

Medicare medical equipment & supply locations

Locations

Practitioners 3

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.

• Chad Guy Jungert, RPH

  • Pharmacist
  • Grangeville, ID
  • NPI 1669427571
  NPD Authorized official
• Amber Hooper

  • Pharmacist
  • Grangeville, ID
  • NPI 1174433403
  NPD (past)
• Alexandra Beth Palmer, RPH

  • Pharmacist
  • Grangeville, ID
  • NPI 1013311190
  NPD (past)

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

{
    "created_epoch": "1200960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210118400000",
    "number": "1386820314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 W MAIN ST",
            "city": "GRANGEVILLE",
            "state": "ID",
            "postal_code": "835301932",
            "telephone_number": "208-983-1090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 W MAIN ST",
            "city": "GRANGEVILLE",
            "state": "ID",
            "postal_code": "835301932",
            "telephone_number": "208-983-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRWIN DRUG INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-22",
        "last_updated": "2008-05-07",
        "status": "A",
        "authorized_official_last_name": "JUNGERT",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "GUY",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "208-983-1090",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "ID",
            "license": "2081CP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807496800",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DME",
            "identifier": "807496700",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Idaho Dept of Health & Welfare Reg 2 Amh
• Idaho Dept of Health & Welfare Reg 2 CMH
• Idaho Dept of Health & Welfare Reg II Amh Grangeville
• Idaho Dept of Health & Welfare Reg II CMH Grangeville
• William Mark Imus Jr., FNP
• Jill M Lane LLC
• Chad Guy Jungert, RPH
• Tricia Klement
• Christina L. Koehler, L.M.P.
• Jill Marie Lane, O.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2008; 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.