Active NPI
Logan Woolson, PHARMD
- Pharmacist
- Sandpoint, ID
National Provider Identifier
1871101113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- P8921
- Practice address
- 604 N Fifth Ave
Sandpoint, ID 83864-1520 - Phone
- (208) 263-1408
- NPI assigned
- Jul 22, 2020
- 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 | P8921 | ID | Primary |
Addresses
Primary practice location
604 N Fifth Ave
Sandpoint, ID 83864-1520
Mailing address
550 Larkspur St Apt B304
Ponderay, ID 83852-5052
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 |
|---|---|---|---|
| P8921 | ID | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sandpoint Super Drug Clinical | Current | Accepting new patients | |
| Sandpoint Drug Inc | Pharmacist | Past | Accepting new patients |
Locations
604 N Fifth Ave
Sandpoint, ID 83864
Phone (208) 263-1408
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Sandpoint, ID
- NPI 1104584739
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595376000000",
"number": "1871101113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "550 LARKSPUR ST APT B304",
"city": "PONDERAY",
"state": "ID",
"postal_code": "838525052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "604 N FIFTH AVE",
"city": "SANDPOINT",
"state": "ID",
"postal_code": "838641520",
"telephone_number": "208-263-1408"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOLSON",
"first_name": "LOGAN",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-07-22",
"last_updated": "2020-07-22",
"certification_date": "2020-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "P8921",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sandpoint, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.