NPIMap

Organization Active NPI

Rider Pharmacy

  • Pharmacy
  • Fairmont, WV
National Provider Identifier
1194155812
Registry record updated Nov 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
RIDER PHARMACY
Practice address
303 Merchant St
Fairmont, WV 26554-5213
Phone
(304) 366-2710
Fax
(304) 366-0426
NPI assigned
Nov 15, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2013

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

Authorized official

Name
Mrs. Courtney Painter
Title
Billing Specialist
Phone
(304) 366-2710

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 1467459545 WV
Pharmacy 333600000X WV 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
Tax ID family
Rider Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1384473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384473600000",
    "number": "1194155812",
    "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": "304-366-0426"
        },
        {
            "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": "304-366-0426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDER PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-15",
        "last_updated": "2013-11-15",
        "status": "A",
        "authorized_official_last_name": "PAINTER",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "BILLING SPECIALIST",
        "authorized_official_telephone_number": "304-366-2710",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "WV",
            "license": "1467459545",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "WV",
            "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 Nov 15, 2013; 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.