MEDICARE: NORCO, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1144910878
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORCO, INC.

Provider Business Mailing Address
First Line	:	1125 W AMITY RD
Second Line	:
City	:	BOISE
State	:	ID
Zip	:	83705-5412
Country	:	US
Telephone Number	:	208-336-1643
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 W MAIN ST STE 105
Second Line	:
City	:	BOISE
State	:	ID
Zip	:	83702-7243
Country	:	US
Telephone Number	:	844-819-4907
Fax Number	:	833-726-1971

Authorized Official
Title or Position	:	CREDENTIALING SPECIALIST
Name	:	AMANDA GOTTS
Credential	:
Telephone Number	:	208-509-3088

Provider Enumeration Date	:	05/08/2023
Last Update Date	:	02/26/2026

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Directions to “NORCO, INC. ” Practice Location

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