Active NPI
Ridleys Family Markets Inc
- Community/Retail Pharmacy
- Casper, WY
National Provider Identifier
1871539643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- R10144
- Legal business name
- RIDLEYS FAMILY MARKETS INC
- Practice address
- 300 SE Wyoming Blvd
Casper, WY 82609-4201 - Phone
- (307) 577-7062
- Fax
- (307) 266-4623
- NPI assigned
- Jun 21, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Todd Wise
- Title
- Pharmacy Coordinator
- Phone
- (801) 358-3365
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | R10144 | WY | Primary |
Addresses
Primary practice location
300 SE Wyoming Blvd
Casper, WY 82609-4201
Mailing address
621 Washington St S
Twin Falls, ID 83301-5519
Phone (208) 324-4633
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2149911 | Other | PK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, WY
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040819001277 | TX | Part B Supplier - Centralized Flu Biller | 8628980299 |
This NPI is an additional NPI on the enrollment Practice locations: Boise, ID |
| O20160808002760 | WY | Part B Supplier - Mass Immunization (Roster Biller Only) | 6709170111 |
4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Casper, WY; Kemmerer, WY; Laramie, WY; Pinedale, WY; Sheridan, WY |
Other NPIs on the same Medicare enrollment 4
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryMember of 3
Organizations this organization is a member of, according to the National Provider Directory.
-
- Community/Retail Pharmacy
- King of Prussia, PA
- NPI 1265659361
Member Of
Locations
300 SE Wyoming Blvd
Casper, WY 82609
Phone (307) 577-7060
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150848000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1524700800000",
"number": "1871539643",
"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": "300 SE WYOMING BLVD",
"city": "CASPER",
"state": "WY",
"postal_code": "826094201",
"telephone_number": "307-577-7062",
"fax_number": "307-266-4623"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RIDLEYS FAMILY MARKETS INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-21",
"last_updated": "2018-04-26",
"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": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "WY",
"license": "R10144",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2149911",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Casper, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.