Organization
RIDLEY'S FAMILY MARKETS, INC
Active
Other names
Ridley's Pharmacy #7156
Organization subpart
No
Provider details
NPI number
Authorized official
CATHI KETTERLING PHARM, D (PHARMACY COORDINATOR)
(208) 324-4633
Entity
Organization
Contact information
Practice address
1000 POCATELLO CREEK RD, POCATELLO, ID 83201-2926
(208) 233-4051
(208) 233-2888
Mailing address
621 WASHINGTON ST S, TWIN FALLS, ID 83301-5519
(208) 233-4051
(208) 233-2888
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
22546RP
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22546RP
STATE LIC
ID
Enumeration date
09/23/2013
Last updated
09/23/2013
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