Sandpoint Super Drug Clinical
NPI 1104584739ActiveOrganization· Family Medicine· Sandpoint, ID
Family Medicine in Sandpoint, Idaho, registered in NPPES in December 2021. The authorized official on file is Scott Porter, PHARMD, Authorized Official.
Overview
| NPI | 1104584739 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 1, 2021 |
| Last updated in NPPES | Mar 24, 2022 |
| Certified by provider | Mar 24, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
| Pharmacy, Clinic Pharmacy | 3336C0002X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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