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LATAH COMMUNITY HEALTH PHARMACY
NPI 1750786356
Pharmacy - Clinic Pharmacy in Moscow, ID

Active since October 27, 2014CLIA 13D2102630 · Waiver
803 S MAIN ST STE 120, MOSCOW, ID 83843(208) 848-8312(208) 882-5606 Get Directions Write a Review

NPPES record last updated: January 5, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 5, 2026, Mar 12, 2025, Aug 21, 2020 and 1 more (4 updates tracked since 2017).

About Latah Community Health Pharmacy NPPES

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

LATAH COMMUNITY HEALTH PHARMACY (NPI 1750786356), doing business as Latah Health Pharmacy, is a healthcare organization registered as a clinic pharmacy in Moscow, Idaho and active in the NPI registry since October 2014. The organization holds a CLIA Waiver certificate valid through April 30, 2028 and lists Aaron Wilson, Ceo, as its authorized official.

NPPES Registry Identity

NPI1750786356
Entity TypeOrganization
Primary Taxonomy3336C0002X
Legal Business NameLATAH COMMUNITY HEALTH PHARMACY
Location Address803 S MAIN ST STE 120Moscow, ID 83843-3043
Mailing Address731 N Iron Bridge WaySpokane, WA 99202-4926 · (509) 444-8888
Phone(208) 848-8312
Fax(208) 882-5606
Organization SubpartNo
Authorized OfficialAaron WilsonCeo · (509) 444-8888
Enumeration DateOctober 27, 2014
Last NPPES UpdateJanuary 5, 20264 updates tracked since enumeration
NPPES CertifiedJanuary 5, 2026
✔ NPI 1750786356 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Clinic PharmacySuppliers
Taxonomy Code3336C0002X
License✔ Licensed in ID · 37042RP
Definition
A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.
Also ListedPharmacyTaxonomy 333600000X
Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X
803 S MAIN ST STE 120, Moscow, ID 83843
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Other Names 1

Doing Business AsLatah Health Pharmacy

Other Identifiers 3

Medicaid1750786356ID
Other2148393Pk
Medicaid2073987WA

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 13D2102630

Latah Community Health · Moscow, ID
Active · expires Apr 30, 2028
CLIA Number13D2102630
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateMay 1, 2026
Certificate Expiration DateApril 30, 2028
Laboratory DirectorKim Hassler
Laboratory Phone(509) 444-8888
Laboratory LocationLatah Community Health803 S Main St Ste 120, Moscow, ID 83843
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 20

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

DR. KERI NOEL SULLIVAN-WALKER PHARMD
Pharmacist
803 S MAIN ST STE 120
MOSCOW, ID 83843
Latah County (208) 848-8300
TINA M OVERSTREET SUDP
Counselor (Addiction (Substance Use Disorder))
803 S MAIN ST STE 120
MOSCOW, ID 83843
Latah County (509) 444-8200
CARMEN LEE KOEPL
Dental Hygienist
803 S MAIN ST STE 120
MOSCOW, ID 83843
Latah County (208) 848-8300
DR. MATTHEW RICE DO
Family Medicine
803 S MAIN ST STE 120
MOSCOW, ID 83843
Latah County (208) 848-8300
HEATHER LEI WEDDLE PHARMD
Pharmacist (Ambulatory Care)
803 S MAIN ST STE 120
MOSCOW, ID 83843
Latah County (509) 444-8820
ASHLEY ANN TADEHARA
Dental Hygienist
803 S MAIN ST STE 120
MOSCOW, ID 83843
Latah County (208) 848-8300
HEATHER DIANE CRAWFORD
Dental Hygienist
803 S MAIN ST STE 120
MOSCOW, ID 83843
Latah County (509) 444-8200
SELAM KIFLEMICHAEL PHARMACIST
Pharmacist
803 S MAIN ST STE 120
MOSCOW, ID 83843
Latah County (208) 848-8300

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 Latah Community Health Pharmacy's NPI number?

The NPI number for Latah Community Health Pharmacy is 1750786356. It was assigned to this organization in the NPPES registry on October 27, 2014. The provider is doing business as Latah Health Pharmacy.

Where is Latah Community Health Pharmacy located?

Latah Community Health Pharmacy is located at 803 S Main St Ste 120, Moscow, ID 83843. The listed phone number is (208) 848-8312.

What is Latah Community Health Pharmacy's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Clinic Pharmacy, with taxonomy code 3336C0002X.

Does Latah Community Health Pharmacy hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 13D2102630) is associated with this NPI, valid through April 30, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Latah Community Health Pharmacy 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 41 other insurers list Latah Community Health Pharmacy 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 Latah Community Health Pharmacy was last updated on January 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months 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.