Hells Canyon Health And Wellness Pharmacy, Llc

NPI 1457739989 - Pharmacy - 3336C0003X

NPI Details
NPI 1457739989
Enumeration Date 05/17/2015
Last Updated 01/21/2016
Entity Type Healthcare Provider
Active Over 1 year ago
Authorized Information
Name CHARLES ANDREW CHARLES
Position AUTHORIZED OFFICIAL
Phone (208) 743-5515
Fax (208) 743-0333
Practice Location
523 THAIN RD
LEWISTON ID, 83501, US
Phone (208) 743-5515
Fax (208) 743-0333
Business Location
523 THAIN RD
LEWISTON ID, 83501, US
Phone (208) 743-5515
Fax (208) 743-0333
Toxanomy
Taxonomy Code 3336C0003X
License State Idaho
License Number 38642RP
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According to our database, Hells Canyon Health And Wellness Pharmacy, Llc NPI is 1457739989, taxonomy code is 3336C0003X and license number is 38642RP, license state is located at Idaho. Hells Canyon Health And Wellness Pharmacy, Llc physically located at 523 Thain Rd, Lewiston ID, 83501. NPI Number 1033115704 has the healthcare provider type.

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1457739989 NPI number is provided on an as is basis without warranty of any kind. 1457739989 is maintained by the National Plan & Provider Enumeration System. The contents of Hells Canyon Health And Wellness Pharmacy, Llc are for informational purposes only.