NPIMap

Organization Active NPI

Ridleys Family Markets Inc

  • Community/Retail Pharmacy
  • Pinedale, WY
National Provider Identifier
1891909198
Registry record updated May 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
R10037 Issued in WY
Legal business name
RIDLEYS FAMILY MARKETS INC
Practice address
341 East Pine St
Pinedale, WY 82941
Phone
(307) 367-4451
Fax
(307) 367-6651
NPI assigned
May 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2018

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)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X R10037 WY Primary

Addresses

Primary practice location

341 East Pine St
Pinedale, WY 82941

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
2111624OtherPK
1891909198MedicaidWY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 Directory
Tax ID family
Ridley's 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

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525219200000",
    "number": "1891909198",
    "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": "341 EAST PINE ST",
            "city": "PINEDALE",
            "state": "WY",
            "postal_code": "82941",
            "telephone_number": "307-367-4451",
            "fax_number": "307-367-6651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDLEYS FAMILY MARKETS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2018-05-02",
        "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": "R10037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2111624",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891909198",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinedale, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 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.

Verify at the official NPI Registry.