Organization
TNT APOTHECARY LLC
Active
Parent organization
TNT APOTHECARY, LLC
Other names
Glenns Ferry Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
TNT APOTHECARY, LLC
Authorized official
THOMAS GILL WADSWORTH (OWNER)
(907) 786-6211
Entity
Organization
Contact information
Practice address
30 IDAHO AVE, GLENNS FERRY, ID 83623
(208) 536-5761
Mailing address
PO BOX 487, WENDELL, ID 83355-0487
(208) 536-5761
(208) 536-5852
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
10/30/2017
Last updated
06/16/2018
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