NPI age
18 years
Enumerated 2008-03-27
● Active Type 2 · Organization
Idaho State University
Idaho State University is 1 of 11 pharmacy organizations in Idaho.
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
Mailing address
921 S 8th Ave Stop 8311
Pocatello, ID 832090002
Authorized official
Gina Davis
Pharmacy Manager
📞 2082823407
Specialties
-
Pharmacy PrimaryA pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 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
Practice context
Single-site organization. Only one practice location on file.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.