NPI age
4 years
Enumerated 2021-12-08
● Active Type 2 · Organization
Subpart
Community Council Of Idaho, Inc
Community Council Of Idaho, Inc is 1 of 397 pharmacy organizations in Idaho.
Primary specialty
Pharmacy
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Coulson
Pharmacy Director
Last NPPES update
2023-04-04
Source: monthly bulk 2026-05
How this organization compares
Across 397 active pharmacy providers in Idaho.
NPI age
4 years
↓ 15 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2021 → 2026
2021-12Enumerated in NPPES
2021
2026
Where they practice
Primary practice location
2100 Alan St
Idaho Falls, ID 83404
Mailing address
2100 Alan St
Idaho Falls, ID 834045801
Authorized official
Troy Coulson, PHARMD
Pharmacy Director
📞 2084707979
Individual providers at this organization
9 individual providers on file at this primary practice address.
- Lauren Casper, PA Physician Assistant NPI 1245994037
- Lilia Chavez Social Worker NPI 1285279141
- Troy Coulson, PHARMD Pharmacist NPI 1528419447
- William May, LMFT Marriage & Family Therapist NPI 1801037551
- Raymond Price, PA Family Medicine NPI 1932674553
- Noemi Rivas Briones, FNP-C Nurse Practitioner NPI 1619657020
- Ronald Sebreros, LCSW Social Worker NPI 1386901627
- Joshua Tew, PA-C Family Medicine NPI 1679997779
- Matthew Widdison, MD Family Medicine NPI 1932789260
Specialties
-
Pharmacy PrimaryA pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the...
Other names on file (2)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Community Family Clinic Pharmacy 340 B
-
Community Family Clinic Pharmacy 340 B
Practice context
Multi-provider organization. 9 individual providers on file at this primary address.
Subpart of Community Council Of Idaho, Inc.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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