Organization
PRESCRIPTION CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NED HILLYARD (CCO)
(208) 709-4571
Entity
Organization
Contact information
Practice address
2252 CORONADO ST, IDAHO FALLS, ID 83404-7552
(208) 523-3360
(208) 523-3387
Mailing address
2252 CORONADO ST, IDAHO FALLS, ID 83404-7552
(208) 523-3360
(208) 523-3387
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
3336M0003X
Managed Care Organization Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002296700
—
ID
05
—
002296800
—
ID
Enumeration date
05/31/2005
Last updated
01/12/2021
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