Healthcare Provider Details

I. General information

NPI: 1881515096
Provider Name (Legal Business Name): ASHLYN RIDGEWAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 N WALNUT ST
CAMERON MO
64429-8800
US

IV. Provider business mailing address

2000 N WALNUT ST
CAMERON MO
64429-8800
US

V. Phone/Fax

Practice location:
  • Phone: 816-632-2282
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2026034227
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: