NPIMap

Organization Active NPI

Deblaquiere Enterprises Inc

  • Community/Retail Pharmacy
  • Sandpoint, ID
National Provider Identifier
1891783668
Registry record updated Dec 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
1786RP Issued in ID
Legal business name
DEBLAQUIERE ENTERPRISES INC
Practice address
1319 Highway 2 Ste a
Sandpoint, ID 83864-2729
Phone
(208) 263-9080
Fax
(208) 255-1695
NPI assigned
Oct 6, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2019

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

Authorized official

Name
Shannon McGlashan
Title
Corp. Secretary
Phone
(208) 448-1633

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 1786RP ID Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

1319 Highway 2 Ste a
Sandpoint, ID 83864-2729

Mailing address

1319 Highway 2
Ste a
Sandpoint, ID 83864-2711
Phone (208) 263-9080

Other identifiers 3

IdentifierTypeStateIssuer
807059400MedicaidID
002464700MedicaidID
2021876OtherPK

Other names 1

  • WHITE CROSS PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930099106 ID DME Supplier - PharmacyDME Supplier - Prosthetic PersonnelDME Supplier - Orthotic Personnel 8820202765 Practice locations: Sandpoint, ID
O20101013000584 ID Part B Supplier - Mass Immunization (Roster Biller Only) 8820202765 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Oldtown, ID; Priest River, ID; Sandpoint, ID; Spirit Lake, ID

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

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

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
13D1045241White Cross Pharmacy1319 Highway 2 #a, Sandpoint, ID 83864Certificate of waiverSep 8, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
White Cross Pharmacy Sandpoint1319 Highway 2, Sandpoint, ID 83864-2729(208) 263-9080 Blood Glucose Monitors/Supplies (Non-Mail Order)|Canes and/or Crutches|Walkers|Urological Supplies|Enteral Nutrients|Nebulizer Equipment and/or Supplies|Surgical Dressings Does not accept assignmentParticipating since Jul 16, 2002

National Provider Directory

National Provider Directory
Tax ID family
Deblaquiere Enterprises Inc5 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

1205 Highway 2
Ste 102
Sandpoint, ID 83864
Phone (208) 610-7992

NPI Registry JSON

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575417600000",
    "number": "1891783668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 HIGHWAY 2",
            "address_2": "STE A",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838642711",
            "telephone_number": "208-263-9080",
            "fax_number": "208-255-1695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 HIGHWAY 2 STE A",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838642729",
            "telephone_number": "208-263-9080",
            "fax_number": "208-255-1695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBLAQUIERE ENTERPRISES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-06",
        "last_updated": "2019-12-04",
        "status": "A",
        "authorized_official_last_name": "MCGLASHAN",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "CORP. SECRETARY",
        "authorized_official_telephone_number": "208-448-1633"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "ID",
            "license": "1786RP",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807059400",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002464700",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2021876",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WHITE CROSS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WHITE CROSS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 4, 2019; 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.