NPIMap

Organization Active NPI

Maag Prescription Center L.L.C.

  • Oxygen Equipment & Supplies (DME)
  • Pocatello, ID
National Provider Identifier
1669512257
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
License
526CP Issued in ID
Legal business name
MAAG PRESCRIPTION CENTER L.L.C.
Practice address
333 W Center St
Pocatello, ID 83204-3243
Phone
(208) 233-2063
NPI assigned
Feb 6, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Troy Paz
Title
GM
Phone
(208) 233-2063

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oxygen Equipment & Supplies (DME) 332BX2000X 526CP ID Primary

Addresses

Primary practice location

333 W Center St
Pocatello, ID 83204-3243

Mailing address

PO Box 115
Pocatello, ID 83204-0115
Phone (208) 233-2063

Other identifiers 2

IdentifierTypeStateIssuer
8589-4OtherIDBLUE CROSS OF IDAHO
000010014150OtherIDBLUE SHIELD OF ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930020833 ID DME Supplier - PharmacyDME Supplier - Medical Supply CompanyDME Supplier - Medical Supply Company With Registered PharmacistDME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Oxygen & Equipment 7315156643 Practice locations: Pocatello, ID

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Maag Prescription Center LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669512257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 115",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832040115",
            "telephone_number": "208-233-2063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 W CENTER ST",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832043243",
            "telephone_number": "208-233-2063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAAG PRESCRIPTION CENTER L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PAZ",
        "authorized_official_first_name": "TROY",
        "authorized_official_title_or_position": "GM",
        "authorized_official_telephone_number": "208-233-2063"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "ID",
            "license": "526CP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "8589-4",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF ID",
            "identifier": "000010014150",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.