NPIMap

Organization Active NPI

Sunnyside Drug

  • Durable Medical Equipment & Medical Supplies
  • Osburn, ID
National Provider Identifier
1871748012
Registry record updated Dec 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
13-02354489 Issued in ID
Legal business name
SUNNYSIDE DRUG
Practice address
805 E Mullan Ave
Osburn, ID 83849
Phone
(208) 556-1139
NPI assigned
Dec 1, 2008
Last updated
Dec 1, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
OSBURN DRUG COMPANYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 1, 2008

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

Authorized official

Name
Ron Lavigne
Title
President
Phone
(208) 556-1139

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 13-02354489 ID Primary

Addresses

Primary practice location

805 E Mullan Ave
Osburn, ID 83849

Mailing address

805 E Mullan Ave
Osburn, ID 83849
Phone (208) 556-1139

National Provider Directory

National Provider Directory
Tax ID family
Sunnyside Drug3 organizations share this tax ID, including this one
Part of
Sunnyside Drug

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228089600000",
    "number": "1871748012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 E MULLAN AVE",
            "city": "OSBURN",
            "state": "ID",
            "postal_code": "83849",
            "telephone_number": "208-556-1139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 E MULLAN AVE",
            "city": "OSBURN",
            "state": "ID",
            "postal_code": "83849",
            "telephone_number": "208-556-1139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNNYSIDE DRUG",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OSBURN DRUG COMPANY",
        "enumeration_date": "2008-12-01",
        "last_updated": "2008-12-01",
        "status": "A",
        "authorized_official_last_name": "LAVIGNE",
        "authorized_official_first_name": "RON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-556-1139"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "ID",
            "license": "13-02354489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Osburn, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.