KENNETH CARLIN K.C. ROOSE
NPI 1790566404
Pharmacist in Ammon, ID

Active since October 09, 2023
3250 E 17TH ST, AMMON, ID 83406(208) 552-7677 Get Directions Write a Review

NPPES record last updated: October 9, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kenneth Carlin K.c. Roose NPPES

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

KENNETH CARLIN K.C. ROOSE (NPI 1790566404) is an individual pharmacist in Ammon, Idaho, licensed in Idaho (P10920) and active in the NPI registry since October 2023.

NPPES Registry Identity

NPI1790566404
Entity TypeIndividualMale
Primary Taxonomy183500000X
Provider Legal NameKENNETH CARLIN K.C. ROOSE
Location Address3250 E 17TH STAmmon, ID 83406-6758
Mailing Address5504 Calen LnChubbuck, ID 83202-2296 · (801) 792-7902
Sole ProprietorYes
Enumeration DateOctober 9, 2023
NPPES CertifiedOctober 9, 2023
NPI 1790566404 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License Licensed in ID · P10920
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.
3250 E 17TH ST, Ammon, ID 83406

Other Providers at the Same Location NPPES 12

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

Pharmacist (Geriatric)
3250 E 17TH ST
AMMON, ID 83406
Pharmacist
3250 E 17TH ST
AMMON, ID 83406
Pharmacist
3250 E 17TH ST
AMMON, ID 83406
Pharmacist
3250 E 17TH ST
AMMON, ID 83406
Durable Medical Equipment & Medical Supplies
3250 E 17TH ST
AMMON, ID 83406
Pharmacy (Community/Retail Pharmacy)
3250 E 17TH ST
AMMON, ID 83406
Pharmacy (Long Term Care Pharmacy)
3250 E 17TH ST
AMMON, ID 83406
Pharmacy (Long Term Care Pharmacy)
3250 E 17TH ST
AMMON, ID 83406

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 Kenneth Carlin Roose's NPI number?

The NPI number for Kenneth Carlin Roose is 1790566404. It was assigned to this individual provider in the NPPES registry on October 9, 2023.

Where is Kenneth Carlin Roose located?

Kenneth Carlin Roose practices at 3250 E 17th St, Ammon, ID 83406. The listed phone number is (208) 552-7677.

What is Kenneth Carlin Roose's specialty?

The primary specialty registered for this NPI is Pharmacist with taxonomy code 183500000X.

When was this NPI record last updated?

The NPPES record for Kenneth Carlin Roose was last updated on October 9, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.