Provider Demographics
NPI:1528173903
Name:MEDNOW INC
Entity type:Organization
Organization Name:MEDNOW INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BILL
Authorized Official - Middle Name:
Authorized Official - Last Name:BECK
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:208-895-1957
Mailing Address - Street 1:323 E RIVERSIDE DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:EAGLE
Mailing Address - State:ID
Mailing Address - Zip Code:83616-6864
Mailing Address - Country:US
Mailing Address - Phone:208-938-2136
Mailing Address - Fax:208-938-2137
Practice Address - Street 1:323 E RIVERSIDE DR
Practice Address - Street 2:SUITE 120
Practice Address - City:EAGLE
Practice Address - State:ID
Practice Address - Zip Code:83616-6864
Practice Address - Country:US
Practice Address - Phone:208-938-2136
Practice Address - Fax:208-938-2137
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
ID1123CP332B00000X, 333600000X, 332BP3500X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000010013833OtherREGENCE BS & HEALTH SENSE
ID002582900Medicaid
ID85233OtherBLUE CROSS& TRUE BLUE
ID002583200OtherMEDICAID PROFESSIONAL
ID002583200OtherMEDICAID PROFESSIONAL
ID002582900Medicaid