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Contact Information

CLEARWATER CANYON PHARMACY, LLC
13020 US-12
OROFINO, ID83544
 Phone: 208-476-0110
 Fax: 208-476-0115
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for CLEARWATER CANYON PHARMACY, LLC

NPI # 1598229809
LBN Legal business name CLEARWATER CANYON PHARMACY, LLC
Authorized official CHARLES POTTENGER - (OWNER/PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 01/31/2019
Last updated 04/10/2019 - About 7 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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