NPIMap

Organization Active NPI

Community Council of Idaho, Inc.

Doing business as Community Family Clinic Pharmacy Non-340B

  • Community/Retail Pharmacy
  • Rigby, ID
National Provider Identifier
1881389393
Registry record updated Apr 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
COMMUNITY COUNCIL OF IDAHO, INC.
Doing business as
Community Family Clinic Pharmacy Non-340B
Practice address
4002 E 397 N
Rigby, ID 83442
Phone
(208) 470-7979
Fax
(888) 626-5817
NPI assigned
Apr 10, 2023
Last updated
Apr 10, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY COUNCIL OF IDAHO, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 10, 2023

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

Authorized official

Name
Troy Coulson, PHARMDNPI 1528419447
Title
Pharmacy Director
Phone
(208) 470-7979

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

4002 E 397 N
Rigby, ID 83442

Mailing address

2100 Alan St
Idaho Falls, ID 83404-5801
Phone (208) 470-7979

Other names 1

  • Community Family Clinic Pharmacy Non-340B Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Idaho Migrant Council Inc8 organizations share this tax ID, including this one
Part of
Idaho Migrant Council Inc

Other organizations with this tax ID 7

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1681084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681084800000",
    "number": "1881389393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 ALAN ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834045801",
            "telephone_number": "208-470-7979",
            "fax_number": "888-626-5817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4002 E 397 N",
            "city": "RIGBY",
            "state": "ID",
            "postal_code": "83442",
            "telephone_number": "208-470-7979",
            "fax_number": "888-626-5817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY COUNCIL OF IDAHO, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY COUNCIL OF IDAHO, INC.",
        "enumeration_date": "2023-04-10",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-04",
        "status": "A",
        "authorized_official_last_name": "COULSON",
        "authorized_official_first_name": "TROY",
        "authorized_official_title_or_position": "PHARMACY DIRECTOR",
        "authorized_official_telephone_number": "208-470-7979",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Family Clinic Pharmacy Non-340B",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rigby, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; 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.