NPIMap

Organization Active NPI

Ridley's Family Markets Inc

Doing business as Wendell Pharmacy

  • Community/Retail Pharmacy
  • Wendell, ID
National Provider Identifier
1023671807
Registry record updated Apr 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
RIDLEY'S FAMILY MARKETS INC
Doing business as
Wendell Pharmacy
Practice address
280 S Idaho St
Wendell, ID 83355-5200
Phone
(208) 536-5761
Fax
(208) 536-5852
NPI assigned
Apr 17, 2019
Last updated
Apr 17, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2019

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

Authorized official

Name
Todd Robert WiseNPI 1801310925
Title
Director of Pharmacy
Phone
(801) 358-3365

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

280 S Idaho St
Wendell, ID 83355-5200

Mailing address

621 Washington St S
Twin Falls, ID 83301-5519
Phone (801) 358-3365

Other names 1

  • Wendell Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20160817003238 ID Part B Supplier - Mass Immunization (Roster Biller Only) 6709170111 13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wendell, ID; Blackfoot, ID; Weiser, ID; Star, ID; Rupert, ID; Pocatello, ID; Kuna, ID; Kimberly, ID…
O20200310002257 ID DME Supplier - Pharmacy 6709170111 Practice locations: Wendell, ID
O20200527003434 ID Part B Supplier - Pharmacy 6709170111 Practice locations: Wendell, ID

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory
Tax ID family
Ridleys Family Markets Inc36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

Organizations that report the same tax identification number in the National Provider Directory.

View all 35

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1555459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555459200000",
    "number": "1023671807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 WASHINGTON ST S",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015519",
            "telephone_number": "801-358-3365",
            "fax_number": "208-567-5622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 S IDAHO ST",
            "city": "WENDELL",
            "state": "ID",
            "postal_code": "833555200",
            "telephone_number": "208-536-5761",
            "fax_number": "208-536-5852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDLEY'S FAMILY MARKETS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-17",
        "last_updated": "2019-04-17",
        "status": "A",
        "authorized_official_last_name": "WISE",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "801-358-3365"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wendell Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wendell, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.