Rider Pharmacy Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

AR5100792 Issued in WV

Legal business name

RIDER PHARMACY INC

Doing business as

Rider Pharmacy

Practice address

303 Merchant St
Fairmont, WV 26554-5213

Phone

(304) 366-2710

Fax

(304) 366-3116

NPI assigned

Jul 5, 2005

Last updated

Jun 7, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jonathan Rider

Title

Owner

Phone

(304) 366-2710

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• RIDER PHARMACY Doing business as

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1496793600000",
    "number": "1467459545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 MERCHANT STREET",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265552138",
            "telephone_number": "304-366-2710",
            "fax_number": "304-366-3201"
        },
        {
            "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": "304-366-3116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDER PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-05",
        "last_updated": "2017-06-07",
        "status": "A",
        "authorized_official_last_name": "RIDER",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-366-2710"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "WV",
            "license": "AR5100792",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014225200",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "5001019",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "042783001",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RIDER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gina Ridenour
• Trista D Ridenour
• Rider Pharmacy
• Rider Pharmacy Group (Rider Pharmacy Inc)
• Rider Pharmacy Inc
• Heather Rider, PT
• Devin M Riegel
• Montana Lynn Riegel, LPN
• Melanie C Rieser
• Deborah Ann Rife

• Pharmacy in Fairmont, WV
• Providers in Fairmont, WV by specialty
• Pharmacy in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2017; 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.