Organization
RIDLEYS FAMILY MARKETS INC
Active
Other names
Ridley's Pharmacy #1165
Organization subpart
No
Provider details
NPI number
Authorized official
TODD WISE (PHARMACY DIRECTOR)
(801) 358-3365
Entity
Organization
Contact information
Practice address
4045 E PONY EXPRESS PKWY, EAGLE MOUNTAIN, UT 84005-5512
(801) 789-4997
(801) 789-4993
Mailing address
621 WASHINGTON ST S, TWIN FALLS, ID 83301-5519
(208) 324-4633
(208) 324-1190
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
87123051703
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548681877
—
UT
01
—
2143719
PK
—
Enumeration date
01/06/2014
Last updated
07/19/2018
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