Organization
RIDLEYS FAMILY MARKETS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD WISE (PHARMACY COORDINATOR)
(801) 358-3365
Entity
Organization
Contact information
Practice address
169 COFFEEN AVE, SHERIDAN, WY 82801-4804
(307) 672-1788
(307) 672-5206
Mailing address
621 WASHINGTON ST S, TWIN FALLS, ID 83301-5519
(208) 324-4633
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
R10141
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2149909
PK
—
Enumeration date
11/26/2007
Last updated
04/26/2018
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