Rider Drug Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

004254 Issued in MO

Legal business name

RIDER DRUG INC

Practice address

1207 S Baltimore St
Kirksville, MO 63501-4528

Phone

(660) 665-4666

Fax

(660) 665-2257

NPI assigned

Oct 31, 2006

Organization subpart

No

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

Authorized official

Name

Craig Harris, RPHNPI 1740012624

Title

Owner Phcst

Phone

(660) 665-4666

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• RIDER DRUG INC Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Craig Harris

  • Pharmacist
  • Kirksville, MO
  • NPI 1740012624
  NPD Authorized official
• Teresa Harris

  • Pharmacist
  • Kirksville, MO
  • NPI 1518799493
  NPD
• India Deann Herrmann, PHARM.D.

  • Pharmacist
  • Kirksville, MO
  • NPI 1902332323
  NPD (past)

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670198400000",
    "number": "1215014188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 S BALTIMORE ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635014528",
            "telephone_number": "660-665-4666",
            "fax_number": "660-665-2257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 S BALTIMORE ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635014528",
            "telephone_number": "660-665-4666",
            "fax_number": "660-665-2257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDER DRUG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "OWNER PHCST",
        "authorized_official_telephone_number": "660-665-4666",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "004254",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RI600131510",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2049000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RIDER DRUG INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Renew Counseling LLC
• Rex O Lee D O P C
• Leslie J Reynolds, PTA
• Andrea Greenlee Richards, MED CCC SLP
• Ian Richmond, PLPC
• Mary Ridgeway
• Donald Dean Riley, DDS
• Sarah Rimer, RN
• Carissa Riney
• Ripley Emergency Group, LLC

• Community/Retail Pharmacy in Kirksville, MO
• Providers in Kirksville, MO by specialty
• Community/Retail Pharmacy in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.