Ridge Maud Drug Corporation

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

002239 Issued in MO

Legal business name

RIDGE MAUD DRUG CORPORATION

Practice address

910 N Westwood Blvd
Poplar Bluff, MO 63901-4242

Phone

(573) 785-8218

Fax

(573) 785-8125

NPI assigned

Nov 3, 2006

Organization subpart

No

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

Authorized official

Name

Martin Michel, RPH MBA CDENPI 1891872446

Title

Owner

Phone

(573) 785-8218

Specialties & licenses 6

Addresses

Other identifiers 2

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Ridge Maud Drug Corporation

  • Pharmacy
  • Poplar Bluff, MO
  • NPI 1538204532
  NPPES parent name

Practitioners 2

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

• Martin H Michel, R.PH., M.B.A., C.D.E

  • Pharmacist
  • Poplar Bluff, MO
  • NPI 1891872446
  NPD Authorized official
• Lauren Goodwin

  • Pharmacist
  • Poplar Bluff, MO
  • NPI 1366039414
  NPD

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1275612947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 N WESTWOOD BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639014242",
            "telephone_number": "573-785-8218",
            "fax_number": "573-785-8125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 N WESTWOOD BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639014242",
            "telephone_number": "573-785-8218",
            "fax_number": "573-785-8125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGE MAUD DRUG CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "MICHEL",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-785-8218",
        "authorized_official_credential": "RPH MBA CDE"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "002239",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "MO",
            "license": "002239",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2609519",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600125603",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adam Joseph Richter, DO
• Natalie Grace Ricker
• Riley Jo Rickman, AUD
• Taqdees Rida
• Kacee Rider
• Ridge Maud Drug Corporation
• Matthew J Riffle, M.D.
• Dean Rigby, MD
• Brianne Riggins, R.D., L.D.
• Savannah Risby

• Community/Retail Pharmacy in Poplar Bluff, MO
• Providers in Poplar Bluff, 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 Jul 24, 2024; 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.