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Organization

TETON PHARMACY IN AMMON

Active
Parent organization
TETON CLINICAL PHARMACY INC
Other names
Teton Pharmacy in Ammon
Organization subpart
Yes

Provider details

NPI number
Legal business name
TETON CLINICAL PHARMACY INC
Authorized official
PHILIP HARPER DMD (OWNER)
(208) 529-3638
Entity
Organization

Contact information

Practice address
3160 E 17TH ST STE 164, AMMON, ID 83406-6784
(208) 529-1795
(208) 529-1838
Mailing address
2470 JAFER CT, IDAHO FALLS, ID 83404-5587
(208) 529-3636
(208) 529-1715

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1043629397
ID
05
1831561034
ID
01
2154929
PK
Enumeration date
10/27/2015
Last updated
04/29/2019
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