Organization
RIDLEY'S FAMILY MARKETS INC
Active
Other names
Ridley's pharmacy#1163
Organization subpart
No
Provider details
NPI number
Authorized official
TODD WISE (PHARMACY COORDINATOR)
(801) 358-3365
Entity
Organization
Contact information
Practice address
620 PINE AVE, KEMMERER, WY 83101-3002
(307) 877-4209
(307) 877-6254
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
R10071
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2131834
PK
—
Enumeration date
08/29/2011
Last updated
09/24/2020
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