Organization
PRESCRIPTION CENTER HOME CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NED HILLYARD (OWNER/MANAGER)
(208) 709-4571
Entity
Organization
Contact information
Practice address
2250 CORONADO ST, IDAHO FALLS, ID 83404-7552
(208) 528-7979
(208) 523-2238
Mailing address
2250 CORONADO ST, IDAHO FALLS, ID 83404-7552
(208) 528-7979
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
333600000X
Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002645900
—
ID
05
—
002646000
—
ID
Enumeration date
05/31/2005
Last updated
01/12/2021
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