NPIMap

Organization Active NPI

Super Save Highland Pharmacy

  • Durable Medical Equipment & Medical Supplies
  • Pocatello, ID
National Provider Identifier
1437145240
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
11537CP Issued in ID
Legal business name
SUPER SAVE HIGHLAND PHARMACY
Practice address
755 Hospital Way
Suite B1
Pocatello, ID 83201-4869
Phone
(208) 237-9393
Fax
(208) 237-6017
NPI assigned
Sep 27, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Tori Daniel Shaver
Title
Vice President
Phone
(208) 232-9392

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 11537CP ID Primary

Addresses

Primary practice location

755 Hospital Way
Suite B1
Pocatello, ID 83201-4869

Mailing address

755 Hospital Way B1
P O Box 4869
Pocatello, ID 83205-4869
Phone (208) 237-9393

National Provider Directory

National Provider Directory
Tax ID family
Super Save Highland Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437145240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 HOSPITAL WAY B1",
            "address_2": "P O BOX 4869",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832054869",
            "telephone_number": "208-237-9393",
            "fax_number": "208-237-6017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 HOSPITAL WAY",
            "address_2": "SUITE B1",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014869",
            "telephone_number": "208-237-9393",
            "fax_number": "208-237-6017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPER SAVE HIGHLAND PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHAVER",
        "authorized_official_first_name": "TORI",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "208-232-9392",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "ID",
            "license": "11537CP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 2020; 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.