Organization
CLEARWATER CANYON PHARMACY, LLC
Active
Other names
Clearwater Canyon Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES ANDREW POTTENGER PHARMD (OWNER/PRESIDENT)
(208) 476-0110
Entity
Organization
Contact information
Practice address
13020 US-12, OROFINO, ID 83544
(208) 476-0110
(208) 476-0115
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
—
—
Other
Enumeration date
01/31/2019
Last updated
04/10/2019
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up