NPIMap

Organization Active NPI

Ridleys Family Markets Inc

  • Community/Retail Pharmacy
  • Buhl, ID
National Provider Identifier
1609196351
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
2412RP Issued in ID
Legal business name
RIDLEYS FAMILY MARKETS INC
Practice address
705 Highway 30
Buhl, ID 83316-5054
Phone
(208) 543-9944
Fax
(208) 543-2338
NPI assigned
Jun 4, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2018

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

Authorized official

Name
Todd Wise, DOC OF PHARMACY
Title
Pharmacy Coordinator
Phone
(801) 358-3365

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 2412RP ID Primary

Addresses

Primary practice location

705 Highway 30
Buhl, ID 83316-5054

Mailing address

621 Washington St S
Twin Falls, ID 83301-5519
Phone (208) 423-4248

Other identifiers 2

IdentifierTypeStateIssuer
2125371OtherPK
1609196351MedicaidID

Other names 1

  • Ridleys Pharmacy #8446 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160817003238 ID Part B Supplier - Mass Immunization (Roster Biller Only) 6709170111 13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wendell, ID; Blackfoot, ID; Weiser, ID; Star, ID; Rupert, ID; Pocatello, ID; Kuna, ID; Kimberly, ID…

National Provider Directory

National Provider Directory
Tax ID family
Ridley'S Family Markets Inc36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

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

View all 35

Locations

1295 Parkway Dr
Blackfoot, ID 83221
Phone (208) 785-1311

705 Highway 30
#8446
Buhl, ID 83316
Phone (208) 543-9944

705 Highway 30
Buhl, ID 83316
Phone (208) 543-9944

1427 Main St
Gooding, ID 83330
Phone (208) 934-4709

1427 Main St
#8445
Gooding, ID 83330
Phone (208) 934-4709

1016 S Lincoln Ave
Jerome, ID 83338
Phone (208) 324-2411

1016 S Lincoln Ave
#8443
Jerome, ID 83338
Phone (208) 324-2411

210 Main St S
Kimberly, ID 83341
Phone (208) 423-4248

210 Main St S
#8464
Kimberly, ID 83341
Phone (208) 423-4248

911 N Main St
#7152
Pocatello, ID 83204
Phone (208) 478-8510

310 Oneida St
#8447
Rupert, ID 83350
Phone (208) 436-1200

25 W Center St
Orem, UT 84057
Phone (801) 224-3684

341 Pine St
Pinedale, WY 82941
Phone (307) 367-4451

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1275609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1609196351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 WASHINGTON ST S",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015519",
            "telephone_number": "208-423-4248",
            "fax_number": "208-423-5767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 HIGHWAY 30",
            "city": "BUHL",
            "state": "ID",
            "postal_code": "833165054",
            "telephone_number": "208-543-9944",
            "fax_number": "208-543-2338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDLEYS FAMILY MARKETS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-04",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "WISE",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "PHARMACY COORDINATOR",
        "authorized_official_telephone_number": "801-358-3365",
        "authorized_official_credential": "DOC OF PHARMACY"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "ID",
            "license": "2412RP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2125371",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609196351",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ridleys Pharmacy #8446",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Buhl, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.