Organization
RIDLEY'S FAMILY MARKETS, INC
Active
Other names
Ridley's Pharmacy #8464
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CATHI KETTERLING PHARMD (PRESIDENT)
(208) 324-4633
Entity
Organization
Contact information
Practice address
210 MAIN ST. SOUTH, KIMBERLY, ID 83341-0443
(208) 423-4248
(208) 423-5767
Mailing address
621 WASHINGTON ST. SOUTH, TWIN FALLS, ID 83301-5519
(208) 324-4633
(208) 324-1190
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
1730 CP
ID
3336C0003X
Community/Retail Pharmacy
Primary
1730CP
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806621200
—
ID
Enumeration date
02/26/2007
Last updated
05/17/2016
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