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General NPI Number Information
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NPI Number | 1053860767
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Entity Type | Organization
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Legal Business Name | GOODING PHARMACY INC
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Dates
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Enumeration Date | 09/23/2016
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Last Update Date | 11/14/2025
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Provider Practice Location Address
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Address Line | 653 SOUTH BEVERLY STREET
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City | SHOSHONE
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State | ID
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Zip | 83352
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Country | US
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Telephone | 208-934-4000
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Fax | 208-886-2220
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Provider Business Mailing Address
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Address Line | 653 S BEVERLY ST
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City | SHOSHONE
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State | ID
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Zip | 83352-5121
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Country | US
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Telephone | 208-886-2000
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Fax | 208-886-2220
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Authorized Official
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Title or Position | PRESIDENT
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Name | JASON READING
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Credential |
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Telephone | 208-324-3784
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 43300LS
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License Number State | ID
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