Active NPI
Kriders Inc
- Pharmacy
- Green Bay, WI
National Provider Identifier
1326023664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- KRIDERS INC
- Practice address
- 1119 W Mason St
Green Bay, WI 54303-1895 - Phone
- (920) 499-6225
- Fax
- (920) 499-4544
- NPI assigned
- Dec 9, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Gary Brian Krider, RPH
- Title
- Owner
- Phone
- (920) 499-6772
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | WI | Primary |
Addresses
Primary practice location
1119 W Mason St
Green Bay, WI 54303-1895
Mailing address
1119 W Mason St
Green Bay, WI 54303-1895
Phone (920) 499-6225
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33090100 | Medicaid | WI |
National Provider Directory
National Provider DirectoryLocations
1119 W Mason St
Green Bay, WI 54303
Phone (920) 499-6225
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134086400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1326023664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1119 W MASON ST",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543031895",
"telephone_number": "920-499-6225",
"fax_number": "920-499-4544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1119 W MASON ST",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543031895",
"telephone_number": "920-499-6225",
"fax_number": "920-499-4544"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KRIDERS INC",
"organizational_subpart": "NO",
"enumeration_date": "2005-12-09",
"last_updated": "2025-09-11",
"status": "A",
"authorized_official_last_name": "KRIDER",
"authorized_official_first_name": "GARY",
"authorized_official_middle_name": "BRIAN",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "920-499-6772",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "WI",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "33090100",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.