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Provider Information for 1659396257


The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.

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RALPHS GROCERY COMPANY

Other Names:  
Doing Business As: 
RALPHS PHARMACY

Organization Subpart: NO

NPI: 1659396257
Last Updated: 2018-11-07
Certification Date:

Details

NameValue
NPI1659396257
Enumeration Date2006-07-13
NPI TypeNPI-2 Organization
StatusActive
Authorized Official Information Name: JESSIE WARMAN
Title: MANAGER OF PHARMACY LICENSING
Phone: 5137621019
Mailing Address PO BOX 842772
BOSTON, MA 02284-2772
United States

Phone: 513-762-1019 | Fax:513-762-1092
 
Primary Practice Address 315 E ALESSANDRO BLVD
RIVERSIDE, CA 92508-2463
United States

Phone: 951-789-0928 | Fax:951-789-1614
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)2116327PK
MEDICAIDCAPHA448200
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 332B00000X - Durable Medical Equipment & Medical Supplies
No 333600000X - Pharmacy
Yes 3336C0003X - Pharmacy - Community/Retail PharmacyCAPHY44820