Hells Canyon Pharmacy

LBN: Hells Canyon Health And Wellness Pharmacy
Hells Canyon Pharmacy is an health care organization with primary practice located at 523 Thain Rd , Lewiston ID 83501. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Hells Canyon Health And Wellness Pharmacy can be contacted via phone (208) 743-5515, or through Pottenger, Charles Andrew via phone (208) 743-5515.

Contact Information

Primary practice address
523 Thain Rd Lewiston ID 83501
Fax: (208) 743-0333
Website:
Authorized official contact:
Name: Pottenger, Charles Andrew PHARM D

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X 38642RP Idaho
Suppliers / Compounding Pharmacy 3336C0004X

Profile Details

NPI number 1457739989
LBN Legal business name Hells Canyon Health And Wellness Pharmacy
DBA Doing business as Hells Canyon Pharmacy
Authorized official Pottenger, Charles Andrew PHARM D
Entity Organization
Organization subpart 1 No
Enumeration date May 17th, 2015
Last updated Sep 15th, 2021 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457739989 NPPES
Idaho MEDICAID 1457739989

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