NPI age
19 years
Enumerated 2006-08-31
● Active Type 2 · Organization
Medicine Man Pharmacy Inc
Medicine Man Pharmacy Inc is 1 of 397 pharmacy organizations in Idaho.
Primary specialty
Pharmacy
Plus 1 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Jorgensen
President
Last NPPES update
2013-07-01
Source: monthly bulk 2026-05
How this organization compares
Across 397 active pharmacy providers in Idaho.
NPI age
19 years
≈ at median (19 yr)
Practice locations
1
0 secondary on file
Subspecialties
1
In the 70% of peers with subspecialties
NPI lifetime · 2006 → 2026
2006-08Enumerated in NPPES
2006
2026
Where they practice
Primary practice location
1114 W Ironwood Dr
Coeur D Alene, ID 838142605
Mailing address
1114 W Ironwood Dr
Coeur D Alene, ID 838142605
Authorized official
Brian Jorgensen, RPH
President
📞 2086662502
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Allen Ortmann, RPH Pharmacist NPI 1851687495
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...
-
PharmacyA facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 002541100 | |
| 05 (ID) | 002541200 | |
| 01 | 2020458 | PK |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
MEDICINE MAN PHARMACY INC
Practice context
Multi-provider organization. 1 individual provider on file at this primary address.
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- 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.