Organization
RIDER PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. COURTNEY PAINTER (BILLING SPECIALIST)
(304) 366-2710
Entity
Organization
Contact information
Practice address
303 MERCHANT ST, FAIRMONT, WV 26554-5213
(304) 366-2710
(304) 366-0426
Mailing address
303 MERCHANT ST, FAIRMONT, WV 26554-5213
(304) 366-2710
(304) 366-0426
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
1467459545
WV
333600000X
Pharmacy
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0142252000
—
WV
Enumeration date
11/15/2013
Last updated
11/15/2013
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