NPI age
14 years
Enumerated 2011-10-03
● Active Type 2 · Organization
Subpart
Advanced Healthcare Solutions Llc
Advanced Healthcare Solutions Llc is 1 of 14 non-pharmacy dispensing site organizations in Idaho.
Primary specialty
Non-Pharmacy Dispensing Site
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Vawdrey
Coo
Last NPPES update
2011-10-03
Source: monthly bulk 2026-05
How this organization compares
Across 14 active non-pharmacy dispensing site providers in Idaho.
NPI age
14 years
≈ at median (13 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2011 → 2026
2011-10Enumerated in NPPES
2011
2026
Where they practice
Primary practice location
950 Hospital Way
Pocatello, ID 832012789
Mailing address
2980 N Beverly Glen Cir Ste 301
Los Angeles, CA 900771735
Authorized official
Randy Vawdrey, NP
Coo
📞 2082320021
Individual providers at this organization
5 individual providers on file at this primary practice address.
- Jenna Castillo, PA-C Physician Assistant NPI 1326651035
- Gregory Ford, MD Orthopaedic Surgery NPI 1104928670
- Bryce Larsen, D.M.D. Dentist NPI 1821210535
- Niels Larsen, D.D.S. Dentist NPI 1770796070
- Tanner Mitton, PA-C Physician Assistant NPI 1144601865
Specialties
-
Non-Pharmacy Dispensing Site PrimaryA site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Physicians Immediate Care Center
Practice context
Multi-provider organization. 5 individual providers on file at this primary address.
Subpart of Advanced Heallhcare Solutions Llc.
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Request a quote →How to verify this organization
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.