Healthcare Provider Details

I. General information

NPI: 1699325415
Provider Name (Legal Business Name): ROCKLAND PHARMACY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2019
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

524 TYHEE AVE
AMERICAN FALLS ID
83211-1224
US

IV. Provider business mailing address

524 TYHEE AVE
AMERICAN FALLS ID
83211-1224
US

V. Phone/Fax

Practice location:
  • Phone: 208-226-2411
  • Fax: 208-226-5124
Mailing address:
  • Phone: 208-226-2411
  • Fax: 208-226-5124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: PHILIP SCOTT ANDERSON
Title or Position: PHARMACIST/OWNER
Credential: PHARMD
Phone: 208-226-2411