Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

TRACY LYNN BIDEGANETA RPH
NPI 1215910229
Pharmacist in Mountain Home, ID

Active since November 22, 2005
270 N 2ND E, MOUNTAIN HOME, ID 83647(208) 587-3346(208) 587-2052 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Tracy Lynn Bideganeta Rph NPPES

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

TRACY LYNN BIDEGANETA RPH (NPI 1215910229) is an individual pharmacist in Mountain Home, Idaho, licensed in Idaho (P4566) and active in the NPI registry since November 2005.

NPPES Registry Identity

NPI1215910229
Entity TypeIndividualFemale
Primary Taxonomy183500000X
Provider Legal NameTRACY LYNN BIDEGANETACredential: RPH
Location Address270 N 2ND EMountain Home, ID 83647-2725
Mailing Address270 N 2nd EMountain Home, ID 83647-2725 · (208) 587-2368 · Fax (208) 587-2052
Fax(208) 587-2052
Sole ProprietorNo
Enumeration DateNovember 22, 2005
Last NPPES UpdateJuly 13, 2026
NPI 1215910229 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License Licensed in ID · P4566
Definition

An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

270 N 2ND E, Mountain Home, ID 83647

Other Names 1

Former Name (1)Tracy Lynn Cantrell Rph

Other Providers at the Same Location NPPES

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

Pharmacist
270 N 2ND E
MOUNTAIN HOME, ID 83647

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1215910229, enumerated as an "individual" on November 22, 2005.

The provider is located at 270 N 2ND E MOUNTAIN HOME, ID 83647 and the phone number is (208) 587-3346.

Pharmacist with taxonomy code 183500000X.