Healthcare Provider Details

I. General information

NPI: 1326035585
Provider Name (Legal Business Name): SANDPOINT DRUG INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2005
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 N FIFTH AVE
SANDPOINT ID
83864-1520
US

IV. Provider business mailing address

604 N FIFTH AVE
SANDPOINT ID
83864-1520
US

V. Phone/Fax

Practice location:
  • Phone: 208-263-1408
  • Fax: 208-265-8784
Mailing address:
  • Phone: 208-263-1408
  • Fax: 208-265-8784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number StateID

VIII. Authorized Official

Name: MR. SCOTT ALLEN PORTER
Title or Position: PHARMACIST/MANAGER
Credential: R.PH.,PHARM.D.
Phone: 208-263-1408