Penny Wise Drug Stores Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

302RP Issued in ID

Legal business name

PENNY WISE DRUG STORES INC

Practice address

802 Cleveland Blvd
Caldwell, ID 83605-4149

Phone

(208) 459-3691

Fax

(208) 459-0189

NPI assigned

Dec 18, 2006

Organization subpart

No

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

Authorized official

Name

Thomas Wilson

Title

Sece Treas

Phone

(208) 459-2134

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• PENNY WISE DRUG Doing business as

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412035200000",
    "number": "1730242355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 278",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836060278",
            "telephone_number": "208-459-3691",
            "fax_number": "208-459-0189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 CLEVELAND BLVD",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054149",
            "telephone_number": "208-459-3691",
            "fax_number": "208-459-0189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNY WISE DRUG STORES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2014-09-30",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "SECE TREAS",
        "authorized_official_telephone_number": "208-459-2134"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "ID",
            "license": "302RP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003088000",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2019725",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003087600",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PENNY WISE DRUG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Caldwell, ID
• Providers in Caldwell, ID by specialty
• Community/Retail Pharmacy in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.