Teton Pharmacy of Rigby LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

44146RP Issued in ID

Legal business name

TETON PHARMACY OF RIGBY LLC

Doing business as

Teton Pharmacy of Rigby

Practice address

527 Rigby Lake Dr Ste C
Rigby, ID 83442-5117

Phone

(208) 745-9450

Fax

(208) 745-9465

NPI assigned

Jan 23, 2017

Last updated

Mar 6, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jason Bailey

Title

Owner

Phone

(208) 529-3636

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Teton Pharmacy of Rigby Doing business as

Locations

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

{
    "created_epoch": "1485129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488758400000",
    "number": "1942747472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2470 JAFER CT",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834045587",
            "telephone_number": "208-529-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 RIGBY LAKE DR STE C",
            "city": "RIGBY",
            "state": "ID",
            "postal_code": "834425117",
            "telephone_number": "208-745-9450",
            "fax_number": "208-745-9465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TETON PHARMACY OF RIGBY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-23",
        "last_updated": "2017-03-06",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-529-3636"
    },
    "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": "44146RP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2166778",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Teton Pharmacy of Rigby",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Rigby, ID
• Providers in Rigby, 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 Mar 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.