NPIMap

Organization Active NPI

Pharmacy Shop Inc

Doing business as Ed Snells Pharmacy Shop

  • Oxygen Equipment & Supplies (DME)
  • Pocatello, ID
National Provider Identifier
1487813457
Registry record updated Apr 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
Legal business name
PHARMACY SHOP INC
Doing business as
Ed Snells Pharmacy Shop
Practice address
1015 E Young St
Pocatello, ID 83201-5282
Phone
(208) 233-0049
NPI assigned
Jun 5, 2008
Last updated
Apr 14, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2011

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

Authorized official

Name
Mr. Ed SnellNPI 1104828870
Title
Owner
Phone
(208) 233-0049

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oxygen Equipment & Supplies (DME) 332BX2000X ID Primary

Addresses

Primary practice location

1015 E Young St
Pocatello, ID 83201-5282

Mailing address

1015 E Young St
Pocatello, ID 83201-5282
Phone (208) 233-0049

Other identifiers 1

IdentifierTypeStateIssuer
002631600MedicaidID

Other names 1

  • ED SNELLS PHARMACY SHOP Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302739200000",
    "number": "1487813457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 E YOUNG ST",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015282",
            "telephone_number": "208-233-0049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 E YOUNG ST",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015282",
            "telephone_number": "208-233-0049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMACY SHOP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-05",
        "last_updated": "2011-04-14",
        "status": "A",
        "authorized_official_last_name": "SNELL",
        "authorized_official_first_name": "ED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-233-0049",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002631600",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ED SNELLS PHARMACY SHOP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 14, 2011; 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.