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MEDICINE MAN ATHOL PHARMACY
NPI 1851894380
Pharmacy - Community/Retail Pharmacy in Hayden, ID

Active since March 11, 2018
30585 N ROBERTS RD, HAYDEN, ID 83835(208) 683-1309(208) 683-1315 Get Directions Write a Review

NPPES record last updated: June 3, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 15, 2018, Apr 19, 2018, Mar 11, 2018 (3 updates tracked since 2018).

About Medicine Man Athol Pharmacy NPPES

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

MEDICINE MAN ATHOL PHARMACY (NPI 1851894380) is a healthcare organization registered as a community/retail pharmacy in Hayden, Idaho and active in the NPI registry since March 2018. The organization lists Korey E Kreider, Coo, as its authorized official.

NPPES Registry Identity

NPI1851894380
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameMEDICINE MAN NORTH PHARMACY INC
Location Address30585 N ROBERTS RDHayden, ID 83835
Mailing AddressPo Box 1706Hayden, ID 83835-1706 · (208) 683-1309 · Fax (208) 683-1315
Phone(208) 683-1309
Fax(208) 683-1315
Organization SubpartNo
Authorized OfficialKorey E KreiderCoo · (208) 660-3938
Enumeration DateMarch 11, 2018
Last NPPES UpdateJune 3, 20223 updates tracked since enumeration
NPPES CertifiedJune 3, 2022
✔ NPI 1851894380 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 · 47570RP
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
30585 N ROBERTS RD, Hayden, ID 83835
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Other Names 1

Doing Business AsMedicine Man Athol Pharmacy

Other Identifiers 2

Other2176449Pk
Medicaid1851894380ID

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 13D2151278

Medicine Man Athol Pharmacy · Athol, ID
Expired · Jul 16, 2026
CLIA Number13D2151278
Laboratory TypePharmacy
Certificate Effective DateJuly 17, 2024
Certificate Expiration DateJuly 16, 2026
Laboratory DirectorKorey Kreider Pharmacist
Laboratory Phone(208) 683-1309
Laboratory LocationMedicine Man Athol Pharmacy30585 N Roberts Rd, Athol, ID 83801
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims

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.
24 services24 patients

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 1851894380. It was assigned to this organization in the NPPES registry on March 11, 2018. The provider is doing business as Medicine Man Athol Pharmacy.

Where is Medicine Man North Pharmacy Inc located?

Medicine Man North Pharmacy Inc is located at 30585 N Roberts Rd, Hayden, ID 83835. The listed phone number is (208) 683-1309.

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.

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.