Active NPI
Trent Moore
- Pharmacy Technician
- Chubbuck, ID
National Provider Identifier
1790694255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- I75660
- Practice address
- 4845 Yellowstone Ave
Chubbuck, ID 83202-2333 - Phone
- (208) 237-2900
- NPI assigned
- Sep 2, 2026
- 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 |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | I75660 | ID | Primary |
Addresses
Primary practice location
4845 Yellowstone Ave
Chubbuck, ID 83202-2333
Mailing address
4845 Yellowstone Ave
Chubbuck, ID 83202-2333
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788307200000",
"number": "1790694255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4845 YELLOWSTONE AVE",
"city": "CHUBBUCK",
"state": "ID",
"postal_code": "832022333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4845 YELLOWSTONE AVE",
"city": "CHUBBUCK",
"state": "ID",
"postal_code": "832022333",
"telephone_number": "208-237-2900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "TRENT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-09-02",
"last_updated": "2026-09-02",
"certification_date": "2026-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "ID",
"license": "I75660",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chubbuck, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.