Provider Demographics
NPI:1619500238
Name:GOODING PHARMACY INC
Entity Type:Organization
Organization Name:GOODING PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:READING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-681-5897
Mailing Address - Street 1:2392 ADDISON AVE E
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301
Mailing Address - Country:US
Mailing Address - Phone:208-933-2050
Mailing Address - Fax:208-933-2088
Practice Address - Street 1:2392 ADDISON AVE E
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301
Practice Address - Country:US
Practice Address - Phone:208-933-2050
Practice Address - Fax:208-933-2088
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GOODING PHARMACY INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-02-21
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy