Organization
RIDER PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN MICHAEL RIDER (OWNER)
(304) 366-2710
Entity
Organization
Contact information
Practice address
303 MERCHANT ST, FAIRMONT, WV 26554-5213
(304) 366-2710
(304) 366-3201
Mailing address
303 MERCHANT ST, FAIRMONT, WV 26554-5213
(304) 366-2710
(304) 366-3201
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0142252000
—
WV
Enumeration date
05/03/2012
Last updated
03/07/2016
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