Organization
RIDLEYS FAMILY MARKETS INC
Active
Other names
Star Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TODD WISE DOC OF PHARMACY (PHARMACY COORDINATOR)
(801) 358-3365
Entity
Organization
Contact information
Practice address
145 S PLUMMER RD, STAR, ID 83669-6199
(208) 286-0906
(208) 286-0726
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
2413RP
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861712457
—
ID
01
—
2125372
PK
—
Enumeration date
06/04/2010
Last updated
09/07/2022
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