Organization
GRIDER DRUG LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREG GRIDER (MANAGER)
(270) 866-7541
Entity
Organization
Contact information
Practice address
2431B LAKEWAY DR, RUSSELL SPRINGS, KY 42642-4510
(270) 866-7541
Mailing address
2431 LAKEWAY DR STE B, RUSSELL SPRINGS, KY 42642-4648
(270) 866-7541
(270) 866-7542
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
P06731
KY
3336C0003X
Community/Retail Pharmacy
P06731
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4500249000
—
KY
05
—
54008537
—
KY
05
—
90009978
—
KY
Enumeration date
04/06/2006
Last updated
05/13/2026
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