Organization
IDAHO STATE UNIVERSITY
Active
Organization
IDAHO STATE UNIVERSITY
Active
Other names
ISU Pharmacist Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA LEE ROCK (CLINICS DIRECTOR OF OPERATIONS)
(208) 373-1743
Entity
Organization
Contact information
Practice address
4914 YELLOWSTONE AVE STE B, CHUBBUCK, ID 83202-2332
(208) 282-2005
Mailing address
990 S 8TH AVE STOP 8158, POCATELLO, ID 83201-4982
(800) 627-4781
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
—
—
1835P2201X
Ambulatory Care Pharmacist
—
—
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
11/15/2022
Last updated
07/13/2026
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