Grider Drug LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

P06731 Issued in KY

Legal business name

GRIDER DRUG LLC

Practice address

2431B Lakeway Dr
Russell Springs, KY 42642-4510

Phone

(270) 866-7541

NPI assigned

Apr 6, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Greg Grider

Title

Manager

Phone

(270) 866-7541

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778630400000",
    "number": "1013979640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2431 LAKEWAY DR STE B",
            "city": "RUSSELL SPRINGS",
            "state": "KY",
            "postal_code": "426424648",
            "telephone_number": "270-866-7541",
            "fax_number": "270-866-7542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2431B LAKEWAY DR",
            "city": "RUSSELL SPRINGS",
            "state": "KY",
            "postal_code": "426424510",
            "telephone_number": "270-866-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRIDER DRUG LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-06",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A",
        "authorized_official_last_name": "GRIDER",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "270-866-7541",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "KY",
            "license": "P06731",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KY",
            "license": "P06731",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54008537",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4500249000",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90009978",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Miles Kenton Gibson, M.D.
• Laura A Godby, LPCC
• Lisa Annette Goodlett, R.PH
• Angela Denise Gossage, PHARM.D.
• Liesel C Grentz, D.O.
• Eric B Grider
• Jonathan Grider, PHARMD
• Robert Brian Grippe, DMD
• H&H Taxi, LLC
• Vickie Hadley, LPCA

• All providers in Russell Springs, KY
• Durable Medical Equipment & Medical Supplies in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.