Organization
TETON PHARMACY OF RIGBY LLC
Active
Other names
Teton Pharmacy of Rigby
Organization subpart
No
Provider details
NPI number
Authorized official
JASON BAILEY (OWNER)
(208) 529-3636
Entity
Organization
Contact information
Practice address
527 RIGBY LAKE DR STE C, RIGBY, ID 83442-5117
(208) 745-9450
(208) 745-9465
Mailing address
2470 JAFER CT, IDAHO FALLS, ID 83404-5587
(208) 529-3636
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
44146RP
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2166778
PK
—
Enumeration date
01/23/2017
Last updated
03/06/2017
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