Provider Demographics
NPI:1508971987
Name:MEDNOW, INC
Entity Type:Organization
Organization Name:MEDNOW, INC
Other - Org Name:MEDNOW PHARMACY #2
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BILL
Authorized Official - Middle Name:
Authorized Official - Last Name:BECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-895-1957
Mailing Address - Street 1:1512 12TH AVE RD
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-6008
Mailing Address - Country:US
Mailing Address - Phone:208-463-5355
Mailing Address - Fax:208-463-5357
Practice Address - Street 1:1512 12TH AVE RD
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83686-6008
Practice Address - Country:US
Practice Address - Phone:208-463-5355
Practice Address - Fax:208-463-5357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID1134CP332B00000X, 333600000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000010013834OtherREGENCE BS & HEALTH SENSE
ID000010014481OtherREGENCE BS & HEALTH SENSE
ID85233OtherBLUE CROSS OF IDAHO
IDTB409OtherTRUE BLUE
ID002583000Medicaid
OR158212Medicaid
ID805346600OtherMEDICAID PROFESSIONAL
ID805346600OtherMEDICAID PROFESSIONAL
OR158212Medicaid