Reddish Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

693RP Issued in ID

Legal business name

REDDISH PHARMACY INC

Practice address

215 E Hawaii Ave
Ste 100
Nampa, ID 83686-6011

Phone

(208) 466-7823

Fax

(208) 466-8429

NPI assigned

Aug 31, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kevin ReddishNPI 1760029821

Title

President

Phone

(208) 466-7823

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• REDDISH PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kevin Edward Reddish

  • Pharmacist
  • Nampa, ID
  • NPI 1760029821
  NPD Authorized official
• Keely Gregory, PHARMD

  • Pharmacist
  • Nampa, ID
  • NPI 1942574678
  NPD (past)
• Lynne Svedin, PHARM D

  • Pharmacist
  • Nampa, ID
  • NPI 1629795372
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435190400000",
    "number": "1295847135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E HAWAII AVE",
            "address_2": "STE 100",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866011",
            "telephone_number": "208-466-7823",
            "fax_number": "208-466-8429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E HAWAII AVE",
            "address_2": "STE 100",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866011",
            "telephone_number": "208-466-7823",
            "fax_number": "208-466-8429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDDISH PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2015-06-25",
        "status": "A",
        "authorized_official_last_name": "REDDISH",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-466-7823"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "ID",
            "license": "693RP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002584300",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2020587",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "REDDISH PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kade Ready, PA-C
• Rebecca Holmstead, LLC
• Rebekah Scott, LLC
• Cody William Redd Johnson, LPC, NCC
• Phillip James Redd, DO
• Kevin Edward Reddish
• Anthony Bruce Reece, FNP-C
• Brenda Lee Reed, M.S., CCCSLP
• Mark Allen Reed, MPT
• Reendeavor, LLC

• Community/Retail Pharmacy in Nampa, ID
• Providers in Nampa, ID by specialty
• Community/Retail Pharmacy in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.