NPIMap

Organization Active NPI

Rider Pharmacy Inc

  • Pharmacist
  • Fairmont, WV
National Provider Identifier
1013276567
Registry record updated Mar 7, 2016
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Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
Legal business name
RIDER PHARMACY INC
Practice address
303 Merchant St
Fairmont, WV 26554-5213
Phone
(304) 366-2710
Fax
(304) 366-3201
NPI assigned
May 3, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2016

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

Authorized official

Name
Jonathan Michael Rider
Title
Owner
Phone
(304) 366-2710

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X Primary

Addresses

Primary practice location

303 Merchant St
Fairmont, WV 26554-5213

Mailing address

303 Merchant St
Fairmont, WV 26554-5213
Phone (304) 366-2710

Other identifiers 1

IdentifierTypeStateIssuer
0142252000MedicaidWV

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1336003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457308800000",
    "number": "1013276567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 MERCHANT ST",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265545213",
            "telephone_number": "304-366-2710",
            "fax_number": "304-366-3201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 MERCHANT ST",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265545213",
            "telephone_number": "304-366-2710",
            "fax_number": "304-366-3201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDER PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-03",
        "last_updated": "2016-03-07",
        "status": "A",
        "authorized_official_last_name": "RIDER",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-366-2710"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0142252000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairmont, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2016; 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.