Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Idaho State University

Organization Ambulatory Care Pharmacist · NPI 1457060790

Idaho State University is an Ambulatory Care Pharmacist in Chubbuck, Idaho. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
2

Practice location Address checks out

4914 Yellowstone Ave Ste B
Chubbuck, ID 83202-2332
Phone: (208) 282-2005
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Health Service Clinic/Center (primary) Taxonomy 261QH0100X
Ambulatory Care Pharmacist Taxonomy 1835P2201X

Record details

NPI number1457060790
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Cynthia Rock — Clinics Director Of Operations · (208) 373-1743
Other names Isu Pharmacist Clinic; Isu Pharmacist Clinic
NPI enumeratedNovember 15, 2022
Last updated in NPPESJuly 13, 2026
Certification dateJuly 13, 2026
Mailing address990 S 8th Ave Stop 8158, Pocatello, ID 83201-4982

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