Organization
TETON PHARMACY OF ST ANTHONY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON BAILEY PHARM D (OWNER)
(208) 529-3636
Entity
Organization
Contact information
Practice address
104 N BRIDGE ST, SUITE 112, SAINT ANTHONY, ID 83445-1455
(208) 624-4411
(208) 624-4412
Mailing address
2470 JAFER CT, IDAHO FALLS, ID 83404-5587
(208) 624-4411
(208) 624-4412
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
45043LS
ID
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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