NPIMap

Organization Active NPI

Rider Pharmacy Group

  • Health Educator
  • Fairmont, WV
National Provider Identifier
1508280272
Registry record updated Feb 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health EducatorTaxonomy code 174H00000X
License
3975 Issued in WV
Legal business name
RIDER PHARMACY GROUP
Practice address
303 Merchant St
Fairmont, WV 26554-5213
Phone
(304) 366-2710
Fax
(304) 366-3201
NPI assigned
Feb 14, 2014
Organization subpart
Yes
Parent organization
RIDER PHARMACY INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 14, 2014

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

Authorized official

Name
Mrs. Debra A Slates, RPH,CDE
Title
Clinical Pharmacist
Phone
(304) 366-2710

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health EducatorGroup: 193200000X MULTI-SPECIALTY GROUP 174H00000X 3975 WV Primary

Addresses

Primary practice location

303 Merchant St
Fairmont, WV 26554-5213

Mailing address

303 Merchant St
Fairmont, WV 26554-5213
Phone (304) 366-2710

Other identifiers 1

IdentifierTypeStateIssuer
0142252000MedicaidWV

Other names 1

  • Rider Pharmacy Inc Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Rider Pharmacy2 organizations share this tax ID, including this one
Part of
Rider Pharmacy

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1392336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392336000000",
    "number": "1508280272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 MERCHANT ST",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265545213",
            "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": "304-366-3201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDER PHARMACY GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RIDER PHARMACY INC.",
        "enumeration_date": "2014-02-14",
        "last_updated": "2014-02-14",
        "status": "A",
        "authorized_official_last_name": "SLATES",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CLINICAL PHARMACIST",
        "authorized_official_telephone_number": "304-366-2710",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RPH,CDE"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health Educator",
            "state": "WV",
            "license": "3975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0142252000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rider Pharmacy Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairmont, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2014; 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.