Healthcare Provider Details

I. General information

NPI: 1508713066
Provider Name (Legal Business Name): BLUEBIRD BIO-CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2026
Last Update Date: 03/13/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

167 FILLMORE ST
TWIN FALLS ID
83301
US

IV. Provider business mailing address

2976 E STATE ST SUITE 120 UNIT #2016
EAGLE ID
83616
US

V. Phone/Fax

Practice location:
  • Phone: 208-295-0430
  • Fax:
Mailing address:
  • Phone: 208-295-0430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY WOODS
Title or Position: OWNER
Credential: PHARMD
Phone: 208-295-0430