NPIMap

Organization Active NPI

Ridleys Family Markets Inc

  • Community/Retail Pharmacy
  • Laramie, WY
National Provider Identifier
1144404641
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
R10142 Issued in WY
Legal business name
RIDLEYS FAMILY MARKETS INC
Practice address
3112 E Grand Ave
Laramie, WY 82070-5141
Phone
(307) 745-7246
Fax
(307) 742-7392
NPI assigned
Dec 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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

Authorized official

Name
Todd Wise
Title
Pharmacy Coordinator
Phone
(801) 358-3365

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X R10142 WY Primary

Addresses

Primary practice location

3112 E Grand Ave
Laramie, WY 82070-5141

Mailing address

621 Washington St S
Twin Falls, ID 83301-5519
Phone (208) 324-4633

Other identifiers 1

IdentifierTypeStateIssuer
2150154OtherPK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160808002760 WY Part B Supplier - Mass Immunization (Roster Biller Only) 6709170111 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Casper, WY; Kemmerer, WY; Laramie, WY; Pinedale, WY; Sheridan, WY

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Tax ID family
Ridley'S 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

Member of 7

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1198108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669680000000",
    "number": "1144404641",
    "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": "208-324-4633",
            "fax_number": "208-324-1190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3112 E GRAND AVE",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820705141",
            "telephone_number": "307-745-7246",
            "fax_number": "307-742-7392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDLEYS FAMILY MARKETS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-20",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A",
        "authorized_official_last_name": "WISE",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "PHARMACY COORDINATOR",
        "authorized_official_telephone_number": "801-358-3365"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WY",
            "license": "R10142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2150154",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laramie, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; 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.