NPIMap

Organization Active NPI

Gooding Pharmacy Inc

Doing business as Hagerman Valley Pharmacy

  • Community/Retail Pharmacy
  • Hagerman, ID
National Provider Identifier
1821653890
Registry record updated Nov 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
GOODING PHARMACY INC
Doing business as
Hagerman Valley Pharmacy
Practice address
141 N State St Ste D
Hagerman, ID 83332-5505
Phone
(208) 944-2067
Fax
(208) 944-0399
NPI assigned
May 6, 2019
Last updated
Nov 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2025

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

Authorized official

Name
Jason Reading
Title
President
Phone
(208) 681-5897

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

141 N State St Ste D
Hagerman, ID 83332-5505

Mailing address

445 Main St
Gooding, ID 83330-1304
Phone (208) 681-5897

Other names 1

  • Hagerman Valley Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200721001209 ID Part B Supplier - Mass Immunization (Roster Biller Only) 0143644393 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Gooding, ID; Hagerman, ID; Shoshone, ID; Twin Falls, ID

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Gooding Pharmacy5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

141 N State St
Unit D
Hagerman, ID 83332
Phone (208) 944-2067

631 Frogs Lndg
Hagerman, ID 83332
Phone (208) 536-5761

653 S Beverly St
Shoshone, ID 83352
Phone (208) 886-2000

2392 Addison Ave E
Twin Falls, ID 83301
Phone (208) 933-2050

NPI Registry JSON

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

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763078400000",
    "number": "1821653890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 MAIN ST",
            "city": "GOODING",
            "state": "ID",
            "postal_code": "833301304",
            "telephone_number": "208-681-5897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 N STATE ST STE D",
            "city": "HAGERMAN",
            "state": "ID",
            "postal_code": "833325505",
            "telephone_number": "208-944-2067",
            "fax_number": "208-944-0399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODING PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-06",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A",
        "authorized_official_last_name": "READING",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-681-5897"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hagerman Valley Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hagerman, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.