Organization
HB VENTURES RX LLC
Active
Other names
PORTICO PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
PATTI FEENEY BBA (BUSINESS MANAGER)
(208) 288-4341
Entity
Organization
Contact information
Practice address
3355 E LOUISE DR, MERIDIAN, ID 83642-5047
(208) 288-4341
(208) 288-4374
Mailing address
3355 E LOUISE DR, MERIDIAN, ID 83642-5047
(208) 288-4341
(208) 288-4374
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2389RP
ID
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2123967
PK
—
Enumeration date
02/26/2010
Last updated
10/12/2016
About Stedi
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