| NPI | 1619507761 |
|---|---|
| Doing Business As | HELLS CANYON PHARMACY LTC |
| Entity Type | Organization |
| Authorized Contact | CHARLES ANDREW POTTENGER Owner 208-743-5515 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2020-01-16 |
| Last Update Date | 2020-01-16 |