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Organization

COMMUNITY COUNCIL OF IDAHO INC

Active
Parent organization
COMMUNITY COUNCIL OF IDAHO INC
Other names
Community Family Clinic Pharmacy
Organization subpart
Yes

Provider details

NPI number
Legal business name
COMMUNITY COUNCIL OF IDAHO INC
Authorized official
TROY COULSON PHARMD (PHARMACY OPERATIONS OFFICER)
(208) 470-7979
Entity
Organization

Contact information

Practice address
2100 ALAN ST, IDAHO FALLS, ID 83404-5801
(208) 470-7979
(888) 626-5801
Mailing address
2100 ALAN ST, IDAHO FALLS, ID 83404-5801
(208) 470-7979
(888) 626-5801

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0002X
Clinic Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary

Other

Enumeration date
06/10/2026
Last updated
06/10/2026
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