Individual provider Active NPI

Zachary Dugdale

  • Pharmacy Technician
  • Boise, ID
National Provider Identifier
1477319960
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacy TechnicianTaxonomy code 183700000X
License
CT69600 Issued in ID
Practice address
7020 W State St
Boise, ID 83714-7419
Phone
(208) 853-3503
NPI assigned
Feb 22, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X CT69600 ID Primary

Addresses

Primary practice location

7020 W State St
Boise, ID 83714-7419

Mailing address

7020 W State St
Boise, ID 83714-7419
Phone (208) 853-3503

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

State licenses

LicenseStateTypeSpecialty
CT69600IDMDPharmacy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Thrifty Payless Inc PastSince Feb 25, 2024 Accepting new patients
Thrifty Payless Inc PastSince Feb 25, 2024 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1708560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1477319960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7020 W STATE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837147419",
            "telephone_number": "208-853-3503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7020 W STATE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837147419",
            "telephone_number": "208-853-3503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUGDALE",
        "first_name": "ZACHARY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-22",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "ID",
            "license": "CT69600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; 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.