Organization
TNT APOTHECARY LLC
Active
Other names
Wendell Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS WADSWORTH RPH (OWNER/MANAGER)
(208) 536-5761
Entity
Organization
Contact information
Practice address
280 S IDAHO ST, WENDELL, ID 83355-5200
(208) 536-5761
(208) 536-5852
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
2335CP
ID
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2120704
PK
—
Enumeration date
10/20/2006
Last updated
07/09/2014
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