NPIMap

Organization Active NPI

Raleys

  • Community/Retail Pharmacy
  • Rohnert Park, CA
National Provider Identifier
1013027770
Registry record updated Jun 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY53519 Issued in CA
Legal business name
RALEYS
Practice address
100 Raley'S Towne Center
Rohnert Park, CA 94928-2440
Phone
(707) 585-3444
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Helen S Singmaster
Title
Secretary
Phone
(916) 373-6394

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHY53519 CA Primary

Addresses

Primary practice location

100 Raley'S Towne Center
Rohnert Park, CA 94928-2440

Mailing address

500 West Capitol Ave.
West Sacramento, CA 95605-2696
Phone (916) 373-6146

Other identifiers 2

IdentifierTypeStateIssuer
0569977OtherNABP
1013027770MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040831000246 CA Part B Supplier - Mass Immunization (Roster Biller Only) 2365417722 This NPI is an additional NPI on the enrollment
Practice locations: Sacramento, CA; Petaluma, CA; S Lake Tahoe, CA; Rohnert Park, CA; Rohnert, CA; Redding, CA; Red Bluff, CA; Pleasanton, CA…
O20100930017246 CA DME Supplier - Pharmacy 2365417722 Practice locations: Rohnert Park, CA

National Provider Directory

National Provider Directory
Tax ID family
Raleys 24852 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 13

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 13

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433376000000",
    "number": "1013027770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 WEST CAPITOL AVE.",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956052696",
            "telephone_number": "916-373-6146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RALEY'S TOWNE CENTER",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949282440",
            "telephone_number": "707-585-3444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALEYS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2015-06-04",
        "status": "A",
        "authorized_official_last_name": "SINGMASTER",
        "authorized_official_first_name": "HELEN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "916-373-6394"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY53519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "0569977",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013027770",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rohnert Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.