Active NPI
Teton Clinical Pharmacy, Inc.
- Home Health Agency
- Idaho Falls, ID
National Provider Identifier
1992862577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- HH-183
- Legal business name
- TETON CLINICAL PHARMACY, INC.
- Practice address
- 2470 Jafer CT.
Idaho Falls, ID 83404 - Phone
- (208) 529-3636
- Fax
- (208) 529-1715
- NPI assigned
- Jan 2, 2007
- Organization subpart
- Yes
- Parent organization
- TETON PHARMACY HOME HEALTH & HOSPICE
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Jason M Bailey
- Title
- Owner
- Phone
- (208) 529-3636
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | |||
| Home Health Agency | 251E00000X | HH-183 | ID | Primary |
Addresses
Primary practice location
2470 Jafer CT.
Idaho Falls, ID 83404
Mailing address
2470 Jafer CT.
Idaho Falls, ID 83404
Phone (208) 529-3636
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002551600 | Medicaid | ID |
Other names 1
- Teton Pharmacy Home Health & Hospice
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1365120000000",
"number": "1992862577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2470 JAFER CT.",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "83404",
"telephone_number": "208-529-3636",
"fax_number": "208-529-1715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2470 JAFER CT.",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "83404",
"telephone_number": "208-529-3636",
"fax_number": "208-529-1715"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TETON CLINICAL PHARMACY, INC.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "TETON PHARMACY HOME HEALTH & HOSPICE",
"enumeration_date": "2007-01-02",
"last_updated": "2013-04-05",
"status": "A",
"authorized_official_last_name": "BAILEY",
"authorized_official_first_name": "JASON",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "208-529-3636",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "ID",
"license": "HH-183",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "002551600",
"state": "ID"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Teton Pharmacy Home Health & Hospice",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Idaho Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.