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TETON PHARMACY IN AMMON

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Company Details

Name: TETON PHARMACY IN AMMON
Jurisdiction: Idaho
Legal type: Assumed Business Name
Status: Active-Current
Date of registration: 17 Jul 2017 (8 years ago)
Entity Number: 590865
Place of Formation: IDAHO
File Number: 0000590865
ZIP code: 83404
County: Bonneville County
Mailing Address: 2470 JAFER CT IDAHO FALLS, ID 83404

National Provider Identifier

NPI Number:
1831561034

Authorized Person:

Name:
PHILIP HARPER
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
3336C0003X - Community/Retail Pharmacy
Is Primary:
Yes

Contacts:

Fax:
2085291715
Fax:
2085291838

Filing

Filing Name Filing Number Filing date
Initial Filing 0000590865 2017-07-17

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Date of last update: 26 Sep 2024

Sources: Idaho Secretary of State