Active NPI
Angela Pearl Plaida Fusco, PHARMD
- Pharmacist
- Bonners Ferry, ID
National Provider Identifier
1801437934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- P8458
- Practice address
- 6452 Main St
Bonners Ferry, ID 83805-8520 - Phone
- (208) 267-4021
- Fax
- (208) 267-4024
- NPI assigned
- Sep 30, 2019
- Sex
- Female
- 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 | P8458 | ID | Primary |
Addresses
Primary practice location
6452 Main St
Bonners Ferry, ID 83805-8520
Mailing address
6452 Main St
Bonners Ferry, ID 83805-8520
Phone (208) 267-4021
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P8458 | ID | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598486400000",
"number": "1801437934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6452 MAIN ST",
"city": "BONNERS FERRY",
"state": "ID",
"postal_code": "838058520",
"telephone_number": "208-267-4021",
"fax_number": "208-267-4024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6452 MAIN ST",
"city": "BONNERS FERRY",
"state": "ID",
"postal_code": "838058520",
"telephone_number": "208-267-4021",
"fax_number": "208-267-4024"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUSCO",
"first_name": "ANGELA PEARL",
"middle_name": "PLAIDA",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-30",
"last_updated": "2020-08-27",
"certification_date": "2020-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "P8458",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bonners Ferry, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.