Active NPI
Raymond Henry Renouf III
- Pharmacist
- Ashton, ID
National Provider Identifier
1780431494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- P7296
- Practice address
- 23 S 8TH St Ste 2
Ashton, ID 83420-5211 - Phone
- (208) 652-3932
- Fax
- (208) 652-3470
- NPI assigned
- May 1, 2024
- Last updated
- May 1, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | P7296 | ID | Primary |
Addresses
Primary practice location
23 S 8TH St Ste 2
Ashton, ID 83420-5211
Mailing address
1599 Grandview LN
Ashton, ID 83420-5113
Phone (208) 840-0548
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P7296 | ID | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Robert Leland Comstock Jr | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Ashton Community Pharmacy
- Community/Retail Pharmacy
- Ashton, ID
- NPI 1184727240
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1714521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714521600000",
"number": "1780431494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1599 GRANDVIEW LN",
"city": "ASHTON",
"state": "ID",
"postal_code": "834205113",
"telephone_number": "208-840-0548"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23 S 8TH ST STE 2",
"city": "ASHTON",
"state": "ID",
"postal_code": "834205211",
"telephone_number": "208-652-3932",
"fax_number": "208-652-3470"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENOUF",
"first_name": "RAYMOND",
"middle_name": "HENRY",
"name_prefix": "Dr.",
"name_suffix": "III",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-05-01",
"last_updated": "2024-05-01",
"certification_date": "2024-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "P7296",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ashton, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.