Organization
HELLS CANYON HEALTH AND WELLNESS PHARMACY
Active
Parent organization
HELLS CANYON HEALTH AND WELLNESS PHARMACY
Other names
Hells Canyon Pharmacy LTC
Organization subpart
Yes
Provider details
NPI number
Legal business name
HELLS CANYON HEALTH AND WELLNESS PHARMACY
Authorized official
CHARLES ANDREW POTTENGER (OWNER)
(208) 743-5515
Entity
Organization
Contact information
Practice address
523 THAIN RD, LEWISTON, ID 83501-5530
(208) 743-5515
Mailing address
523 THAIN RD, LEWISTON, ID 83501-5530
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
01/16/2020
Last updated
01/16/2020
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