ADAMS COUNTY HEALTH CENTER INC - NPI 1164964219

Q: What is the provider's specialty?

The provider's specialty is Pharmacy with taxonomy code 3336C0003X and a focus in Community/Retail Pharmacy.

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About Adams County Health Center Inc NPPES

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

ADAMS COUNTY HEALTH CENTER INC (NPI 1164964219) is a healthcare organization registered as a community/retail pharmacy in Council, Idaho and active in the NPI registry since November 2016. The organization holds a CLIA Waiver certificate valid through November 6, 2026 and lists Mary Ann Domecq, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1164964219

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameADAMS COUNTY HEALTH CENTER INC

Location Address205 N BERKLEY STCouncil, ID 83612-5015

Mailing AddressPo Box 428Council, ID 83612-0428 · (208) 253-4957 · Fax (208) 253-4958

Phone(208) 253-4957

Fax(208) 253-4958

Organization SubpartNo

Authorized OfficialMary Ann DomecqChief Financial Officer · (208) 253-4242

Enumeration DateNovember 7, 2016

Last NPPES UpdateMarch 13, 20172 updates tracked since enumeration

✔ NPI 1164964219 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers

Taxonomy Code3336C0003X

License✔ Licensed in ID · 43512LS

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

205 N BERKLEY ST, Council, ID 83612

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Other Identifiers 2

Other2166314Pk

Medicare PIN1370011

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Anthem Blue Cross and Blue Shield, Antidote Health Plan of Arizona, Inc. 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 13D0521251

Adams County Health Center · Council, ID

Active · expires Nov 6, 2026

CLIA Number13D0521251

Laboratory TypeFederally Qualified Health Center

Certificate Effective DateNovember 7, 2024

Certificate Expiration DateNovember 6, 2026

Laboratory DirectorChelsy L. Taylor

Laboratory Phone(208) 253-4242

Laboratory LocationAdams County Health Center205 N Berkley St, Council, ID 83612

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 11

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

MONTE ROSCOE EPPICH DDS

Dentist (General Practice)