NPIMap

Organization Active NPI

Ontario Pharmacy Inc

  • Compounding Pharmacy
  • Fruitland, ID
National Provider Identifier
1659700896
Registry record updated Mar 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Compounding PharmacyTaxonomy code 3336C0004X
License
21811LS Issued in ID
Legal business name
ONTARIO PHARMACY INC
Practice address
1118 NW 16TH St # 150B
Fruitland, ID 83619-2271
Phone
(208) 452-3340
Fax
(208) 452-7446
NPI assigned
Nov 8, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2014

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

Authorized official

Name
Robert Wheatley
Title
Pharmacist/Owner
Phone
(208) 452-3340

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X
Compounding Pharmacy 3336C0004X 21811LS ID Primary
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

1118 NW 16TH St # 150B
Fruitland, ID 83619-2271

Mailing address

1118 NW 16TH St # 150B
Fruitland, ID 83619-2271
Phone (208) 452-3340

Other identifiers 1

IdentifierTypeStateIssuer
2142790OtherPK

Other names 1

  • Valley Compounding Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ontario Pharmacy Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1383868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395187200000",
    "number": "1659700896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 NW 16TH ST # 150B",
            "city": "FRUITLAND",
            "state": "ID",
            "postal_code": "836192271",
            "telephone_number": "208-452-3340",
            "fax_number": "208-452-7446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 NW 16TH ST # 150B",
            "city": "FRUITLAND",
            "state": "ID",
            "postal_code": "836192271",
            "telephone_number": "208-452-3340",
            "fax_number": "208-452-7446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONTARIO PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-08",
        "last_updated": "2014-03-19",
        "status": "A",
        "authorized_official_last_name": "WHEATLEY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PHARMACIST/OWNER",
        "authorized_official_telephone_number": "208-452-3340"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "ID",
            "license": "21811LS",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2142790",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Compounding Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fruitland, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2014; 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.