Riverside Pharmacy 2 LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

RIVERSIDE PHARMACY 2 LLC

Doing business as

Riverside Pharmacy 2

Practice address

22 Larry Joe Harless Drive
Gilbert, WV 25621

Phone

(304) 664-3343

Fax

(304) 664-8307

NPI assigned

Mar 18, 2025

Last updated

Mar 18, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Samuel Randolph Ballengee, PHARMDNPI 1508985599

Title

Pharmacist

Phone

(304) 664-3343

Specialties & licenses 1

Addresses

Other names 1

• RIVERSIDE PHARMACY 2 Doing business as

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.

• Samuel Randolph Ballengee, PHARMD

  • Pharmacist
  • Williamson, WV
  • NPI 1508985599
  NPD Authorized official
• 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": "1742256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742256000000",
    "number": "1831999804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 431",
            "address_2": "22 LARRY JOE HARLESS DRIVE",
            "city": "GILBERT",
            "state": "WV",
            "postal_code": "25621",
            "telephone_number": "304-664-3343",
            "fax_number": "304-664-8307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 LARRY JOE HARLESS DRIVE",
            "city": "GILBERT",
            "state": "WV",
            "postal_code": "25621",
            "telephone_number": "304-664-3343",
            "fax_number": "304-664-8307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE PHARMACY 2 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-18",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-14",
        "status": "A",
        "authorized_official_last_name": "BALLENGEE",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "RANDOLPH",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "304-664-3343",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RIVERSIDE PHARMACY 2",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dustin Lee Paige
• Mary Jane Phipps, FNP
• Ashley Price, FNP-C
• Darlene Richards
• Avery B Ritchie, ARDMS
• Riverside Pharmacy Inc
• Amelia J. Santiago, M.D.
• George Smith, R.PH.
• Hailey Smith
• Tina Smith

• 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 Mar 18, 2025; 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.