Organization
RIDER DRUG INC
Active
Other names
RIDER DRUG INC
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG HARRIS RPH (OWNER PHCST)
(660) 665-4666
Entity
Organization
Contact information
Practice address
1207 S BALTIMORE ST, KIRKSVILLE, MO 63501-4528
(660) 665-4666
(660) 665-2257
Mailing address
1207 S BALTIMORE ST, KIRKSVILLE, MO 63501-4528
(660) 665-4666
(660) 665-2257
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
004254
MO
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2049000
PK
—
05
—
RI600131510
—
MO
Enumeration date
10/31/2006
Last updated
12/05/2022
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