NPIMap

Organization Active NPI

Minidoka Memorial Hospital

  • Pharmacy
  • Rupert, ID
National Provider Identifier
1942364070
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
379HP Issued in ID
Legal business name
MINIDOKA MEMORIAL HOSPITAL
Practice address
1224 8TH St
Rupert, ID 83350-1527
Phone
(208) 436-0481
Fax
(208) 436-6038
NPI assigned
Dec 21, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Thomas J Murphy
Title
Administrator
Phone
(208) 436-8141

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 379HP ID Primary

Addresses

Primary practice location

1224 8TH St
Rupert, ID 83350-1527

Mailing address

1224 8TH St
Rupert, ID 83350-1527
Phone (208) 436-0481

Other identifiers 3

IdentifierTypeStateIssuer
379HPOtherIDSTATE BOARD OF PHARMACY
M0023364MedicaidID
1301895OtherNABP (NCPDP)

Other names 1

  • Minidoka Memorial Hospital Pharmacy Other name

National Provider Directory

National Provider Directory
Tax ID family
Minidoka Memorial Hospi5 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.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1942364070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 8TH ST",
            "city": "RUPERT",
            "state": "ID",
            "postal_code": "833501527",
            "telephone_number": "208-436-0481",
            "fax_number": "208-436-6038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 8TH ST",
            "city": "RUPERT",
            "state": "ID",
            "postal_code": "833501527",
            "telephone_number": "208-436-0481",
            "fax_number": "208-436-6038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINIDOKA MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "MURPHY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "208-436-8141"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "ID",
            "license": "379HP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD OF PHARMACY",
            "identifier": "379HP",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "M0023364",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP (NCPDP)",
            "identifier": "1301895",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Minidoka Memorial Hospital Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rupert, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.