NPIMap

Organization Active NPI

Ridleys Family Markets Inc

  • Community/Retail Pharmacy
  • Winnemucca, NV
National Provider Identifier
1710358304
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PH00394 Issued in NV
Legal business name
RIDLEYS FAMILY MARKETS INC
Practice address
1041 Grass Valley Rd
Winnemucca, NV 89445-4208
Phone
(775) 623-2548
Fax
(775) 623-5806
NPI assigned
Oct 8, 2015
Last updated
Sep 25, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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

Authorized official

Name
Todd WiseNPI 1801310925
Title
Pharmacy Coordinator
Phone
(801) 358-3365

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X PH00394 NV Primary

Addresses

Primary practice location

1041 Grass Valley Rd
Winnemucca, NV 89445-4208

Mailing address

621 Washington St S
Twin Falls, ID 83301-5519
Phone (208) 324-4633

Other identifiers 1

IdentifierTypeStateIssuer
2154587OtherPK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161003002388 NV Part B Supplier - Mass Immunization (Roster Biller Only) 6709170111 Practice locations: Ely, NV; Winnemucca, NV

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Ridleys 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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1444262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758758400000",
    "number": "1710358304",
    "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": "208-324-4633",
            "fax_number": "208-324-1190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 GRASS VALLEY RD",
            "city": "WINNEMUCCA",
            "state": "NV",
            "postal_code": "894454208",
            "telephone_number": "775-623-2548",
            "fax_number": "775-623-5806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDLEYS FAMILY MARKETS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-08",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "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"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NV",
            "license": "PH00394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2154587",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winnemucca, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; 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.