Rocky Mountain Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

ROCKY MOUNTAIN PHARMACY, LLC

Practice address

3910 Washington Pkwy Ste a
Idaho Falls, ID 83404-7884

Phone

(208) 528-9658

Fax

(208) 522-4772

NPI assigned

Feb 10, 2020

Organization subpart

No

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

Authorized official

Name

Troy Coulson

Title

Pharmacist in Charge

Phone

(208) 528-9658

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID3 enrollments

Enrollment records 3

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Karleen L Lynes, PHARM.D.

  • Pharmacist
  • Ammon, ID
  • NPI 1205170420
  NPD
• Carl David Vance, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Idaho Falls, ID
  • NPI 1437159423
  NPD
• David Redford Liljenquist, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Idaho Falls, ID
  • NPI 1932109931
  NPD (past)

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

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759881600000",
    "number": "1851923544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3910 WASHINGTON PKWY STE A",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047884",
            "telephone_number": "208-528-9658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3910 WASHINGTON PKWY STE A",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047884",
            "telephone_number": "208-528-9658",
            "fax_number": "208-522-4772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKY MOUNTAIN PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-10",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A",
        "authorized_official_last_name": "COULSON",
        "authorized_official_first_name": "TROY",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "208-528-9658"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rocky Mountain Holdings, LLC (Air Idaho Rescue)
• Rocky Mountain Holdings, LLC (Air Idaho Rescue)
• Rocky Mountain Medical LLC
• Rocky Mountain Medical LLC (Helix Healthcare)
• Rocky Mountain Orthopedic and Regenerative Medicine LLC
• Rocky Mountain Wellness Clinic
• Rocky Mountain Womens Clinic LLC
• Mark Gunther Rodel, LPC
• Rodney H Hillam DDS Ms PA
• Maria Rodriguez-Moncada

• Community/Retail Pharmacy in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Community/Retail Pharmacy in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.