Organization
PRESCRIPTION PAD LLC
Active
Other names
The Prescription Pad
Organization subpart
No
Provider details
NPI number
Authorized official
TRENTON JOHN JENKS PHARMD, BCGP (OWNER)
(208) 452-7075
Entity
Organization
Contact information
Practice address
1620 N WHITLEY DR, FRUITLAND, ID 83619-2129
(208) 452-7075
(208) 452-7446
Mailing address
1620 N WHITLEY DR, FRUITLAND, ID 83619-2129
(208) 452-7075
(208) 452-7446
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
0002947
OR
3336C0003X
Community/Retail Pharmacy
Primary
36033RP
ID
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891102653
—
ID
01
—
2147081
PK
—
Enumeration date
07/14/2014
Last updated
04/12/2023
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