Active NPI
Kimberly Gary Allen, RPH
- Pharmacist
- Preston, ID
National Provider Identifier
1720320260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- P4491
- Practice address
- 44 N 1St E
Pharmacy
Preston, ID 83263-1326 - Phone
- (208) 852-4129
- Fax
- (208) 852-3812
- NPI assigned
- Mar 22, 2013
- Last updated
- Mar 22, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | P4491 | ID | Primary |
| Pharmacist | 183500000X | RPH 43613 | CA |
Addresses
Primary practice location
44 N 1St E
Pharmacy
Preston, ID 83263-1326
Mailing address
44 N 1St E
Pharmacy
Preston, ID 83263-1326
Phone (208) 852-4129
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH 43613 | CA | MD | Pharmacist |
| P4491 | ID | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1363910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363910400000",
"number": "1720320260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44 N 1ST E",
"address_2": "PHARMACY",
"city": "PRESTON",
"state": "ID",
"postal_code": "832631326",
"telephone_number": "208-852-4129",
"fax_number": "208-852-3812"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44 N 1ST E",
"address_2": "PHARMACY",
"city": "PRESTON",
"state": "ID",
"postal_code": "832631326",
"telephone_number": "208-852-4129",
"fax_number": "208-852-3812"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "KIMBERLY",
"middle_name": "GARY",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-03-22",
"last_updated": "2013-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "P4491",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "RPH 43613",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.