Active NPI
CD Pharmacy LLC
Doing business as Red Rock Pharmacy
- Long Term Care Pharmacy
- Meridian, ID
National Provider Identifier
1609365345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- Legal business name
- CD PHARMACY LLC
- Doing business as
- Red Rock Pharmacy
- Practice address
- 2370 S Titanium PL
Meridian, ID 83642-6867 - Phone
- (801) 485-6166
- NPI assigned
- May 8, 2018
- Last updated
- May 8, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kenneth Norris
- Title
- Managing Partner
- Phone
- (801) 485-6166
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Long Term Care Pharmacy | 3336L0003X | NU | Primary |
Addresses
Primary practice location
2370 S Titanium PL
Meridian, ID 83642-6867
Mailing address
450 S 900 E Ste 100
Salt Lake City, UT 84102-2983
Phone (801) 485-6166
Other names 1
- Red Rock Pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20201230001986 | ID | Part B Supplier - Pharmacy | 0143453241 | Practice locations: Meridian, ID |
Other NPIs with the same Medicare PAC ID 2
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 13D2193089 | CD Pharmacy LLC Dba Red Rock Pharmacy | Certificate of waiver | Sep 16, 2026 |
National Provider Directory
National Provider Directory- Tax ID family
- CD Pharmacy LLC
Other organizations with this tax ID 5
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": "1525737600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1525737600000",
"number": "1609365345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "450 S 900 E STE 100",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841022983",
"telephone_number": "801-485-6166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2370 S TITANIUM PL",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836426867",
"telephone_number": "801-485-6166"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CD PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-05-08",
"last_updated": "2018-05-08",
"status": "A",
"authorized_official_last_name": "NORRIS",
"authorized_official_first_name": "KENNETH",
"authorized_official_title_or_position": "MANAGING PARTNER",
"authorized_official_telephone_number": "801-485-6166"
},
"taxonomies": [
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Red Rock Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Meridian, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.