NPIMap

Organization Active NPI

Pharmacy Shop Inc

  • Durable Medical Equipment & Medical Supplies
  • Pocatello, ID
National Provider Identifier
1679639462
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
PHARMACY SHOP INC
Practice address
1015 E Young
Pocatello, ID 83201
Phone
(208) 232-0049
Fax
(208) 232-3963
NPI assigned
Dec 28, 2006
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
Mr. Edward L Snell, RPH CCN
Title
President
Phone
(208) 232-0049

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X ID Primary

Addresses

Primary practice location

1015 E Young
Pocatello, ID 83201

Mailing address

1015 E Young
Pocatello, ID 83201
Phone (208) 232-0049

Other names 1

  • Snells IV & Compounding Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ed Snell'S Pharmacy Shop3 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.

Locations

1015 E Young St
Ste B
Pocatello, ID 83201
Phone (208) 232-0049

Practitioners & affiliated clinicians

Practitioners 1

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": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679639462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 E YOUNG",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "83201",
            "telephone_number": "208-232-0049",
            "fax_number": "208-232-3963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 E YOUNG",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "83201",
            "telephone_number": "208-232-0049",
            "fax_number": "208-232-3963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMACY SHOP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SNELL",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-232-0049",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH CCN"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Snells IV & Compounding Center",
            "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 Aug 22, 2020; 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.