NPIMap

Organization Active NPI

Teton Clinical Pharmacy, Inc.

  • Home Infusion Therapy Pharmacy
  • Idaho Falls, ID
National Provider Identifier
1396802773
Registry record updated Apr 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Infusion Therapy PharmacyTaxonomy code 3336H0001X
License
2226CP Issued in ID
Legal business name
TETON CLINICAL PHARMACY, INC.
Doing business as
Teton Pharmacy Home Health & Hospice
Practice address
2470 Jafer CT.
Idaho Falls, ID 83404
Phone
(208) 529-3636
Fax
(208) 529-1715
NPI assigned
Jan 3, 2007
Organization subpart
Yes
Parent organization
TETON PHARMACY HOME HEALTH & HOSPICEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 5, 2013

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

Authorized official

Name
Ms. Pamela Ann Bailey
Title
Office Manager
Phone
(208) 529-3636

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Infusion Agency 251F00000X
Home Infusion Therapy Pharmacy 3336H0001X 2226CP ID Primary

Addresses

Primary practice location

2470 Jafer CT.
Idaho Falls, ID 83404

Mailing address

2470 Jafer CT.
Idaho Falls, ID 83404
Phone (208) 529-3636

Other identifiers 2

IdentifierTypeStateIssuer
002551700MedicaidID
002551800MedicaidID

Other names 1

  • Teton Pharmacy Home Health & Hospice 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": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365120000000",
    "number": "1396802773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2470 JAFER CT.",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83404",
            "telephone_number": "208-529-3636",
            "fax_number": "208-529-1715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2470 JAFER CT.",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83404",
            "telephone_number": "208-529-3636",
            "fax_number": "208-529-1715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TETON CLINICAL PHARMACY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TETON PHARMACY HOME HEALTH & HOSPICE",
        "enumeration_date": "2007-01-03",
        "last_updated": "2013-04-05",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-529-3636",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "ID",
            "license": "2226CP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002551700",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002551800",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Teton Pharmacy Home Health & Hospice",
            "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 Apr 5, 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.