NPIMap

Organization Active NPI

Northwest Pharmacy Services, Inc.

  • Home Infusion Agency
  • Potlatch, ID
National Provider Identifier
1770040693
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Infusion AgencyTaxonomy code 251F00000X
Legal business name
NORTHWEST PHARMACY SERVICES, INC.
Practice address
210 6TH St
Potlatch, ID 83855-9700
Phone
(208) 875-1212
NPI assigned
Feb 27, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Authorized official

Name
William Ora Edwards IIINPI 1639249428
Title
Owner
Phone
(208) 875-1212

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Infusion Agency 251F00000X Primary
Infusion Therapy Clinic/Center 261QI0500X
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

210 6TH St
Potlatch, ID 83855-9700

Mailing address

PO Box 657
Potlatch, ID 83855-0657

Other identifiers 1

IdentifierTypeStateIssuer
814RPMedicaidID

National Provider Directory

National Provider Directory
Tax ID family
Northwest Pharmacy Serv3 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.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

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": "1551225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736121600000",
    "number": "1770040693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 657",
            "city": "POTLATCH",
            "state": "ID",
            "postal_code": "838550657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 6TH ST",
            "city": "POTLATCH",
            "state": "ID",
            "postal_code": "838559700",
            "telephone_number": "208-875-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST PHARMACY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-27",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-02",
        "status": "A",
        "authorized_official_last_name": "EDWARDS III",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "ORA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-875-1212"
    },
    "taxonomies": [
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "814RP",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Potlatch, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; 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.