P Praxis·MD
● Active Type 2 · Organization

Idaho State University

Pharmacy·Pocatello, ID· NPI 1730351081 · Enumerated 2008 · 18 years on NPI
Idaho State University is 1 of 11 pharmacy organizations in Idaho.
NPI age
18 years
Enumerated 2008-03-27
Primary specialty
Pharmacy
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Davis
Pharmacy Manager
Last NPPES update
2012-02-03
Source: monthly bulk 2026-05

How this organization compares

Across 11 active pharmacy providers in Idaho.

NPI age
18 years
↑ 7 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0

NPI lifetime · 2008 → 2026

2008-03Enumerated in NPPES
2008 2026

Where they practice

Primary practice location
990 South 8th
Pocatello, ID 83209
📞 2082823407
Mailing address
921 S 8th Ave Stop 8311
Pocatello, ID 832090002
📞 2082823407

Authorized official

Gina Davis
Pharmacy Manager
📞 2082823407

Specialties

  • Pharmacy Primary
    A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.
    ID license #349CP taxonomy 3336C0002X

Identifiers

TypeValueNotes
01 1307974 NCPDP PROVIDER IDENTIFICATION NUMBER

Other names on file (1)

Doing-business-as, former, and alternate names recorded by NPPES.

  • Idaho State University Student Health Center Pharmacy
    Type code 3 recorded 2010-06-22

Practice context

Single-site organization. Only one practice location on file.

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How to verify this organization

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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