Organization
GEM STATE PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LOGAN WEAVER PHARMD (PHARMACIST IN CHARGE)
(208) 329-6104
Entity
Organization
Contact information
Practice address
1437 PARK VIEW DR # 200, TWIN FALLS, ID 83301-3250
(208) 329-6104
(208) 609-6290
Mailing address
1516 W BLUE DOWNS ST, MERIDIAN, ID 83642-8496
(208) 329-6104
(208) 609-6290
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
—
—
Other
Enumeration date
07/12/2024
Last updated
04/14/2026
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