Organization Active NPI

Kriders Inc

  • Pharmacy
  • Green Bay, WI
National Provider Identifier
1326023664
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
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

Updated by the provider on Sep 11, 2025

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
33090100MedicaidWI

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.