Individual
DR. TED WIEDMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
800 S INDUSTRY WAY STE 240, MERIDIAN, ID 83642-3559
(208) 884-0669
(208) 955-3291
Mailing address
1863 N ARONMINK WAY, MERIDIAN, ID 83646-1162
(661) 428-7082
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
30904
CA
183500000X
Pharmacist
Primary
P9212
ID
Other
Enumeration date
04/17/2023
Last updated
08/21/2023
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