NPIMap

Organization Active NPI

Osburn Drug

  • Community/Retail Pharmacy
  • Osburn, ID
National Provider Identifier
1891885844
Registry record updated Apr 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
CP245 Issued in ID
Legal business name
OSBURN DRUG
Practice address
805 Mullan Ave.
Osburn, ID 83849
Phone
(208) 556-1139
Fax
(208) 556-7311
NPI assigned
Oct 13, 2006
Last updated
Apr 27, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2010

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

Authorized official

Name
Mr. Ronald Dale Lavigne, R.PH
Title
President
Phone
(208) 556-1139

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X CP245 ID Primary

Addresses

Primary practice location

805 Mullan Ave.
Osburn, ID 83849

Mailing address

P.O. Box 2170
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

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": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272326400000",
    "number": "1891885844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 2170",
            "city": "OSBURN",
            "state": "ID",
            "postal_code": "83849",
            "telephone_number": "208-556-1139",
            "fax_number": "208-556-7311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 MULLAN AVE.",
            "city": "OSBURN",
            "state": "ID",
            "postal_code": "83849",
            "telephone_number": "208-556-1139",
            "fax_number": "208-556-7311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSBURN DRUG",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2010-04-27",
        "status": "A",
        "authorized_official_last_name": "LAVIGNE",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-556-1139",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "ID",
            "license": "CP245",
            "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 Apr 27, 2010; 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.