Organization
IDAHO STATE UNIVERSITY
Active
Other names
ISU Bengal Pharmacy Challis
Organization subpart
No
Provider details
NPI number
Authorized official
RIKKI TRUSSEL PHARMD (PHARMACY MANAGER)
(208) 282-3407
Entity
Organization
Contact information
Practice address
609 CLINIC RD, CHALLIS, ID 83226-0070
(208) 879-4600
(208) 879-5379
Mailing address
990 S 8TH AVE STOP 8158, POCATELLO, ID 83201-4982
(208) 282-2407
(208) 282-6150
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376602680
—
ID
Enumeration date
12/06/2006
Last updated
10/13/2025
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