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PRESCRIPTION CENTER, LLC

Managed Care Organization Pharmacy

Idaho Falls, Idaho

Provider NPI: 1124021456

Organization Information:
Organization Name:  PRESCRIPTION CENTER, LLC


Practice Location:
2252 CORONADO ST  IDAHO FALLS, ID 83404 US
Tel: 208-523-3360  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N332B00000XSuppliers
Durable Medical Equipment & Medical Supplies
N333600000XSuppliers
Pharmacy
N3336C0004XSuppliers
Pharmacy
N3336M0003XSuppliers
Pharmacy
N3336S0011XSuppliers
Pharmacy
Y3336C0003XSuppliers
Pharmacy

Other Provider Identifiers:

IssuerNumberStateType
002296800ID05
002296700ID05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




MANAGED CARE JOBS ID - Page 1



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