Active NPI
North Ridge Pharmacy, Inc.
- Long Term Care Pharmacy
- Missoula, MT
National Provider Identifier
1487100095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- License
- 39645
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180306002450 | MT | Part B Supplier - Mass Immunization (Roster Biller Only) | 5294096376 | Practice locations: Missoula, MT |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Pharmacy Technician
- Victor, MT
- NPI 1891129987
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.