Organization
RIDDLE PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLAKE RICE (PHARMACIST)
(541) 874-2406
Entity
Organization
Contact information
Practice address
142 MAIN STREET, RIDDLE, OR 97469
(541) 874-2406
(541) 874-3256
Mailing address
PO BOX 826, RIDDLE, OR 97469-0826
(541) 874-2406
(541) 874-3256
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
RP0000483CS
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
169490
—
OR
01
—
269347
MEDICAID DME
OR
Enumeration date
05/27/2005
Last updated
05/28/2008
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