NPIMap

Organization Active NPI

Riverside Pharmacy Inc

  • Community/Retail Pharmacy
  • Gilbert, WV
National Provider Identifier
1720206774
Registry record updated Oct 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
SP0552340 Issued in WV
Legal business name
RIVERSIDE PHARMACY INC
Practice address
22 Larry Joe Harless
Gilbert, WV 25621
Phone
(304) 664-3343
NPI assigned
Apr 23, 2007
Last updated
Oct 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2008

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

Authorized official

Name
Mr. Cameron Keith Hatfield, R PHNPI 1871719054
Title
Owner
Phone
(304) 682-8132

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
Durable Medical Equipment & Medical Supplies 332B00000X SP0552340 WV
Community/Retail Pharmacy 3336C0003X SP0552340 WV Primary

Addresses

Primary practice location

22 Larry Joe Harless
Gilbert, WV 25621

Mailing address

PO Box 431
Gilbert, WV 25621-0431
Phone (304) 664-3343

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224460800000",
    "number": "1720206774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 431",
            "city": "GILBERT",
            "state": "WV",
            "postal_code": "256210431",
            "telephone_number": "304-664-3343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 LARRY JOE HARLESS",
            "city": "GILBERT",
            "state": "WV",
            "postal_code": "25621",
            "telephone_number": "304-664-3343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2008-10-20",
        "status": "A",
        "authorized_official_last_name": "HATFIELD",
        "authorized_official_first_name": "CAMERON",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-682-8132",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R PH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "WV",
            "license": "SP0552340",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WV",
            "license": "SP0552340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2008; 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.