NPI: 1598229809 · OROFINO, ID 83544 · Community/Retail Pharmacy · NPI assigned 01/31/2019
| Authorized Official | POTTENGER, CHARLES (OWNER/PRESIDENT) |
| NPI Enumeration Date | 01/31/2019 |
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 12 | $187.25 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| A4253 | Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips | 12 | 12 | $187.25 |