Provider Demographics
NPI:1386467009
Name:RIDLEY'S FAMILY MARKETS, INC
Entity type:Organization
Organization Name:RIDLEY'S FAMILY MARKETS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHAMRACY
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:WISE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-358-3365
Mailing Address - Street 1:621 WASHINGTON ST S
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-6293
Mailing Address - Country:US
Mailing Address - Phone:801-358-3365
Mailing Address - Fax:385-331-5000
Practice Address - Street 1:568 SPRING VALLEY CT
Practice Address - Street 2:
Practice Address - City:SPRING CREEK
Practice Address - State:NV
Practice Address - Zip Code:89815-6821
Practice Address - Country:US
Practice Address - Phone:775-735-9248
Practice Address - Fax:385-331-5000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-01
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy