1164539714 NPI number — RIGGS DRUGS INC

Table of content: DR. REHAN FAROOQI MD (NPI 1922480995)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164539714 NPI number — RIGGS DRUGS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RIGGS DRUGS INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
RIGGS DRUGS STORE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164539714
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/14/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 308
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHETOPA
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
67336-0308
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
308 MAPLE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHETOPA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67336
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
620-236-7272
Provider Business Practice Location Address Fax Number:
620-236-7395
Provider Enumeration Date:
08/23/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CARTER
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
620-236-7272

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X , with the licence number: 210322 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 2-10322 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0004X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0004X , with the licence number: 210322 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336L0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336L0003X , with the licence number: 210322 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: KA2290 . This is a "MEDICARE IMMUNIZATION BILLING ID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2030653 . This is a "PK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 100246890A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4441170001 . This is a "DME MEDICARE PTAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 100444890A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".