Organization
RIDLEYS FAMILY MARKETS INC
Active
Other names
RIDLEYS PHARMACY #8442
Organization subpart
No
Provider details
NPI number
Authorized official
TODD WISE DOC OF PHARMACY (PHARMACY COORDINATOR)
(801) 358-3365
Entity
Organization
Contact information
Practice address
430 E MAIN ST, MIDDLETON, ID 83644-3036
(208) 585-2900
(208) 585-3057
Mailing address
621 WASHINGTON ST S, TWIN FALLS, ID 83301-5519
(208) 324-4633
(208) 324-1190
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1494RP
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2021735
PK
—
05
—
805772400
—
ID
Enumeration date
02/27/2007
Last updated
07/19/2018
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