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General NPI Number Information
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NPI Number | 1053742577
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Entity Type | Organization
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Legal Business Name | GEMSTATE PHARMACY GROUP INC
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Dates
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Enumeration Date | 12/09/2013
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 800 S INDUSTRY WAY STE 330
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City | MERIDIAN
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State | ID
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Zip | 83642-3598
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Country | US
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Telephone | 208-287-3733
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Fax | 208-258-6756
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Provider Business Mailing Address
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Address Line | 851 COHO WAY SUITE 312
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City | BELLINGHAM
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State | WA
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Zip | 98225-2067
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Country | US
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Telephone | 360-685-4270
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Fax | 360-205-7504
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Authorized Official
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Title or Position | GREFFIER
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Name | BLAIR WHITNEY
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Credential |
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Telephone | 360-543-7376
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 40843LS
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License Number State | ID
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