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General NPI Number Information
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NPI Number | 1881697118
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Entity Type | Organization
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Legal Business Name | PRESCRIPTION CENTER HOME CARE, LLC
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 01/12/2021
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Provider Practice Location Address
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Address Line | 2250 CORONADO ST
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City | IDAHO FALLS
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State | ID
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Zip | 83404-7552
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Country | US
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Telephone | 208-528-7979
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Fax | 208-523-2238
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Provider Business Mailing Address
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Address Line | 2250 CORONADO ST
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City | IDAHO FALLS
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State | ID
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Zip | 83404-7552
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Country | US
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Telephone | 208-528-7979
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | MR. NED HILLYARD
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Credential |
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Telephone | 208-709-4571
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number |
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License Number State |
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