Organization
REDDISH PHARMACY INC
Active
Other names
REDDISH PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN REDDISH (PRESIDENT)
(208) 466-7823
Entity
Organization
Contact information
Practice address
215 E HAWAII AVE, STE 100, NAMPA, ID 83686-6011
(208) 466-7823
(208) 466-8429
Mailing address
215 E HAWAII AVE, STE 100, NAMPA, ID 83686-6011
(208) 466-7823
(208) 466-8429
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
693RP
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002584300
—
ID
01
—
2020587
PK
—
Enumeration date
08/31/2006
Last updated
06/25/2015
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