NPI age
11 years
Enumerated 2014-09-23
● Active
Type 1 · Individual
DR. Jeffrey Koudelka, PHARM D
Koudelka is 1 of 3 pharmacist providers in Gooding and 1 of 1739 in Idaho.
Primary specialty
Pharmacist
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2014-09-23
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 1739 active pharmacist providers in Idaho.
NPI age
11 years
≈ at median (10 yr)
State licenses
1 state
13% of peers hold multiple states
Subspecialties
0
15% of peers hold subspecialties
NPI lifetime · 2014 → 2026
2014-09Enumerated in NPPES
2014
2026
Where they practice
Practice location
1427 Main St
Gooding, ID 833301838
Mailing address
1427 Main St
Gooding, ID 833301838
Specialties
-
Pharmacist PrimaryAn individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation,...
Practice context
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.