Ridge Maud Drug Corporation

LBN: Ridge Maud Drug Corporation
Ridge Maud Drug Corporation is an health care organization with primary practice located at 910 N Westwood Blvd , Poplar Bluff MO 63901-4242. The organization recently has 5 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Ridge Maud Drug Corporation can be contacted via phone (573) 785-8218, or through Michel, Martin via phone (573) 785-8218.

Contact Information

Primary practice address
910 N Westwood Blvd Poplar Bluff MO 63901-4242
Phone: (573) 785-8218
Fax: (573) 785-8125
Website:
Map and Directions
Authorized official contact:
Name: Michel, Martin RPH MBA CDE
Phone: (573) 785-8218

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 002239 Missouri
Suppliers / Compounding Pharmacy 3336C0004X
Suppliers / Long Term Care Pharmacy 3336L0003X 002239 Missouri

Profile Details

NPI number 1275612947
LBN Legal business name Ridge Maud Drug Corporation
DBA Doing business as
Authorized official Michel, Martin RPH MBA CDE
Entity Organization
Organization subpart 1 No
Enumeration date Nov 3rd, 2006
Last updated Apr 18th, 2018 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275612947 NPPES
Other 2609519 NCPDP PROVIDER IDENTIFICATION NUMBER
MEDICAID 600125603 NCPDP PROVIDER IDENTIFICATION NUMBER

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