Organization Active NPI

North Ridge Pharmacy, Inc.

  • Long Term Care Pharmacy
  • Missoula, MT
National Provider Identifier
1487100095
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
39645 Issued in MT
Legal business name
NORTH RIDGE PHARMACY, INC.
Practice address
2651 South Ave W Ste 102
Missoula, MT 59804-6403
Phone
(406) 258-7100
Fax
(406) 251-1281
NPI assigned
Sep 1, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Authorized official

Name
James A Weichert
Title
Authorized Official
Phone
(952) 361-8000

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility Supplies (DME) 332BN1400X 39645 MT
Community/Retail Pharmacy 3336C0003X
Institutional Pharmacy 3336I0012X
Long Term Care Pharmacy 3336L0003X 39645 MT Primary

Addresses

Primary practice location

2651 South Ave W Ste 102
Missoula, MT 59804-6403

Mailing address

1107 Hazeltine Blvd
Ste 200
Chaska, MN 55318-1009
Phone (952) 361-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180306002450 MT Part B Supplier - Mass Immunization (Roster Biller Only) 5294096376 Practice locations: Missoula, MT

National Provider Directory

National Provider Directory

Locations

2651 South Ave W
Ste 101
Missoula, MT 59804

2651 South Ave W
Ste 102
Missoula, MT 59804
Phone (406) 258-7100

4718 23rd Ave
Ste 100
Missoula, MT 59803

2824 US Highway 93 N
Ste B
Victor, MT 59875
Phone (406) 642-9898

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731628800000",
    "number": "1487100095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 HAZELTINE BLVD",
            "address_2": "STE 200",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553181009",
            "telephone_number": "952-361-8000",
            "fax_number": "952-361-8060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2651 SOUTH AVE W STE 102",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598046403",
            "telephone_number": "406-258-7100",
            "fax_number": "406-251-1281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH RIDGE PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-01",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A",
        "authorized_official_last_name": "WEICHERT",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "952-361-8000"
    },
    "taxonomies": [
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": "MT",
            "license": "39645",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "MT",
            "license": "39645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; 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.