Organization
HELLS CANYON HEALTH AND WELLNESS PHARMACY
Active
Other names
Hells Canyon Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES ANDREW POTTENGER PHARM D (AUTHORIZED OFFICIAL)
(208) 743-5515
Entity
Organization
Contact information
Practice address
523 THAIN RD, LEWISTON, ID 83501
(208) 743-5515
(208) 743-0333
Mailing address
523 THAIN RD, LEWISTON, ID 83501-5530
(208) 743-5515
(208) 743-0333
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
38642RP
ID
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457739989
—
ID
Enumeration date
05/17/2015
Last updated
01/28/2026
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