Riverside Pharmacy Inc

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

Organization subpart

No

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

Authorized official

Name

Mr. Cameron Keith Hatfield, R PH

Title

Owner

Phone

(304) 682-8132

Specialties & licenses 2

Addresses

Practitioners 1

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

• Gary Lane Cunningham, R.PH.

  • Pharmacist
  • Gilbert, WV
  • NPI 1104042381
  NPD (past)

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": []
}

• Mary Jane Phipps, FNP
• Ashley Price, FNP-C
• Darlene Richards
• Avery B Ritchie, ARDMS
• Riverside Pharmacy 2 LLC
• Amelia J. Santiago, M.D.
• George Smith, R.PH.
• Hailey Smith
• Tina Smith
• Stafford EMS

• Community/Retail Pharmacy in Gilbert, WV
• Providers in Gilbert, WV by specialty
• Community/Retail Pharmacy in West Virginia

• 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.