Organization · Type 2 NPI

Hells Canyon Health and Wellness Pharmacy

Long Term Care Pharmacy · Lewiston, ID

NPI number 1619507761 Active

Practice location

523 Thain Rd
Lewiston, ID 83501-5530

Specialties and licenses

Taxonomy	Code	License
Long Term Care Pharmacy Primary	3336L0003X	None listed

Long Term Care Pharmacy: A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.

7 other providers at this address

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NPI record

NPI: 1619507761
Entity type: Organization (Type 2)
Issued: Jan 16, 2020
Last updated: Jan 16, 2020
Status: Active
Subpart: Yes of Hells Canyon Health and Wellness Pharmacy

Other names

Hells Canyon Pharmacy LTC · doing business as

Authorized official

Charles Andrew Pottenger
Owner
(208) 743-5515

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1619507761

Hells Canyon Health and Wellness Pharmacy's National Provider Identifier is 1619507761, issued on Jan 16, 2020. The primary taxonomy on file is Long Term Care Pharmacy (3336L0003X), and the practice location is in Lewiston, ID. The record was last updated on Jan 16, 2020.