Active NPI
Mandi Marie Forrester, PHARM.D.
- Pharmacist
- Emmett, ID
National Provider Identifier
1437324910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- P6021
- Practice address
- 179 W Highway 52
Emmett, ID 83617-9738 - Phone
- (208) 272-9454
- Fax
- (208) 272-9460
- NPI assigned
- Apr 25, 2008
- Last updated
- Feb 13, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | P6021 | ID | Primary |
Addresses
Primary practice location
179 W Highway 52
Emmett, ID 83617-9738
Mailing address
817 Comanche TRL
Emmett, ID 83617-4012
Phone (208) 908-3948
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P6021 | ID | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329091200000",
"number": "1437324910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "817 COMANCHE TRL",
"city": "EMMETT",
"state": "ID",
"postal_code": "836174012",
"telephone_number": "208-908-3948",
"fax_number": "208-272-9460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "179 W HIGHWAY 52",
"city": "EMMETT",
"state": "ID",
"postal_code": "836179738",
"telephone_number": "208-272-9454",
"fax_number": "208-272-9460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORRESTER",
"first_name": "MANDI",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-25",
"last_updated": "2012-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "P6021",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Emmett, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.