Snake River Pharmacy

Primary specialty

Clinic PharmacyTaxonomy code 3336C0002X

License

44698RP Issued in ID

Legal business name

SNAKE RIVER PHARMACY

Practice address

4750 Yellowstone Ave
Chubbuck, ID 83202-2336

Phone

(208) 240-3733

NPI assigned

May 22, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Brian Lunt, PHARMD

Title

Pharmacist

Phone

(208) 240-3733

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1495411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1740717693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 YELLOWSTONE AVE",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832022336",
            "telephone_number": "208-240-3733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 YELLOWSTONE AVE",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832022336",
            "telephone_number": "208-240-3733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNAKE RIVER PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-22",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LUNT",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "208-240-3733",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "ID",
            "license": "44698RP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic Pharmacy in Chubbuck, ID
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• Clinic Pharmacy in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.