TOM THUMB PHARMACY#2574 – Community/Retail Pharmacy, NPI 1891724852

TOM THUMB PHARMACY#2574 is a healthcare provider. based in Boise, Idaho. specializing in Community/Retail Pharmacy. The organization holds a License No. 22137 (TX). The NPI Number for TOM THUMB PHARMACY#2574 is 1891724852

Main info

Organization
Name
TOM THUMB PHARMACY#2574
NPI
1891724852
Phone
Not provided
Address
250 E PARKCENTER BLVD
Authorized Official
TIFFANY ELIOPULOS ASSISTANT MANAGER, ENROLLMENTS
Enumeration Date
2 July 2006
Last Update Date
2 November 2018
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness80
Years active:19State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for TOM THUMB PHARMACY#2574

  • 250, East Parkcenter Boulevard, Boise, Ada County, Idaho, 83706, United States

    BOISE, ID 837063940

    Phone:

    Type: Mailing

  • Keke's Breakfast Cafe, 3000, South Hulen Street, Fort Worth, Tarrant County, Texas, 76109, United States

    FT WORTH, TX 761091929

    Phone: (817) 570-2960

    Fax: (817) 570-2965

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-09-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2025-08-31 (284 days ago).

Enrollment records

1

Earliest due date

2025-08-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20100930002579OPharmacyTX2025-08-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 83706)

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Reviews

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Frequently asked questions

What unique ID ties claims to TOM THUMB PHARMACY#2574?
NPI 1891724852 is assigned to TOM THUMB PHARMACY#2574 under the national enumeration system.
Is TOM THUMB PHARMACY#2574 currently active in the NPI registry?
CMS-published data lists TOM THUMB PHARMACY#2574 as an active registrant.
What kind of provider is TOM THUMB PHARMACY#2574?
The page reflects Community/Retail Pharmacy for TOM THUMB PHARMACY#2574. Clinical services aligned with this taxonomy classification.
What location shows for TOM THUMB PHARMACY#2574?
We surface Boise, Idaho for TOM THUMB PHARMACY#2574 based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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