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MEDICINE MAN PRAIRIE PHARMACY
NPI 1023179892
Pharmacy - Community/Retail Pharmacy in Hayden, ID

Active since December 13, 2006
8093 N CORNERSTONE DR, HAYDEN, ID 83835(208) 762-9355(208) 762-9198 Get Directions Write a Review

NPPES record last updated: June 3, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 19, 2018, May 15, 2018, Jan 20, 2016 (3 updates tracked since 2016).

About Medicine Man Prairie Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MEDICINE MAN PRAIRIE PHARMACY (NPI 1023179892) is a healthcare organization registered as a community/retail pharmacy in Hayden, Idaho and active in the NPI registry since December 2006. The organization lists Korey E Kreider, Coo, as its authorized official.

NPPES Registry Identity

NPI1023179892
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameMEDICINE MAN NORTH PHARMACY INC
Location Address8093 N CORNERSTONE DRHayden, ID 83835-8753
Mailing Address8093 N Cornerstone DrHayden, ID 83835-8753 · (208) 762-9355 · Fax (208) 762-9198
Phone(208) 762-9355
Fax(208) 762-9198
Organization SubpartNo
Authorized OfficialKorey E KreiderCoo · (208) 660-3938
Enumeration DateDecember 13, 2006
Last NPPES UpdateJune 3, 20223 updates tracked since enumeration
NPPES CertifiedJune 3, 2022
✔ NPI 1023179892 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in ID · 1308RP
Definition
A 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 dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Also ListedPharmacyTaxonomy 333600000X
Also ListedPharmacy · Compounding PharmacyTaxonomy 3336C0004X
8093 N CORNERSTONE DR, Hayden, ID 83835
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Other Names 1

Doing Business AsMedicine Man Prairie Pharmacy

Other Identifiers 2

Other2021452Pk
Medicaid1023179892ID

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 13D0966830

Medicine Man Prairie · Hayden, ID
Expired · Jul 23, 2026
CLIA Number13D0966830
Laboratory TypePharmacy
Certificate Effective DateJuly 24, 2024
Certificate Expiration DateJuly 23, 2026
Laboratory DirectorKorey Kreider Pharmacist
Laboratory Phone(208) 762-9355
Laboratory LocationMedicine Man Prairie8093 N Cornerstone Dr, Hayden, ID 83835
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
59 services59 patients
Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patient's home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patient's home M0201
The Covid-19 vaccine can be administered at your home for convenience and safety. This service is reported once per home, per date, when only the vaccine is given. It's a straightforward process where a medical professional visits your home to give the vaccine.
38 services38 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
35 services35 patients

Medical Equipment Supplier Medicare DMEPOS 2

Medicare supplier enrollment and the product categories Medicine Man Prairie Pharmacy carries, from the Medicare DMEPOS supplier directory.

Medicine Man Prairie Pharmacy

DMEPOS supplier · Hayden, IDOperated by Medicine Man North Pharmacy Inc
⋮

Does not accept Medicare assignment

Medicine Man Prairie Pharmacy has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20662637
Medicare Participant SinceJanuary 1, 1998
Supplier Location8093 N Cornerstone DrHayden, ID 83835
Phone(208) 762-9355
Supplier Specialties
Pharmacy

Medicare Product Categories

Blood Glucose Monitors/Supplies (Non-Mail Order)
Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
Nebulizer Equipment and/or Supplies
Nebulizers, Atomizers, Filters
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. SHAWNA LYNN DANIELS RPH
Pharmacist
8093 N CORNERSTONE DR
HAYDEN, ID 83835
Kootenai County (208) 762-9355
JASON HEAD
Pharmacist
8093 N CORNERSTONE DR
HAYDEN, ID 83835
Kootenai County (208) 762-9355
CHAX BRANDON PETERSON PHARM. D.
Pharmacist
8093 N CORNERSTONE DR
HAYDEN, ID 83835
Kootenai County (208) 762-9355
JACE DEVON ROGERS PHARMD
Pharmacist
8093 N CORNERSTONE DR
HAYDEN, ID 83835
Kootenai County (208) 762-9355

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Medicine Man North Pharmacy Inc's NPI number?

The NPI number for Medicine Man North Pharmacy Inc is 1023179892. It was assigned to this organization in the NPPES registry on December 13, 2006. The provider is doing business as Medicine Man Prairie Pharmacy.

Where is Medicine Man North Pharmacy Inc located?

Medicine Man North Pharmacy Inc is located at 8093 N Cornerstone Dr, Hayden, ID 83835. The listed phone number is (208) 762-9355.

What is Medicine Man North Pharmacy Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Medicine Man North Pharmacy Inc accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, Medicine Man Prairie Pharmacy does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

What insurance does Medicine Man North Pharmacy Inc accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 48 other insurers list Medicine Man North Pharmacy Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Medicine Man North Pharmacy Inc was last updated on June 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.