# CONTINUED CARE LTC PHARMACY IDAHO LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609430479
- **Authorized official:** BRANDON HAGEN (GENERAL MANAGER)
- **Authorized official phone:** (888) 557-4318

## Contact information

- **Practice address:** 9196 W EMERALD ST STE 125, BOISE, ID 83704-9049
- **Practice address phone:** (888) 277-2132
- **Mailing address:** PO BOX 1250, RIVERTON, UT 84065-1250

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 04/27/2019
- **Last updated:** 08/13/2024