Organization Active NPI

Randalls Food & Drugs LP

Doing business as Tom Thumb Pharmacy #2526

  • Community/Retail Pharmacy
  • Richardson, TX
National Provider Identifier
1063448843
Registry record updated Nov 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
22119 Issued in TX
Legal business name
RANDALLS FOOD & DRUGS LP
Doing business as
Tom Thumb Pharmacy #2526
Practice address
39 Arapaho Village SC
Richardson, TX 75080
Phone
(972) 680-9717
Fax
(972) 231-3159
NPI assigned
Jun 24, 2006
Organization subpart
Yes
Parent organization
SAFEWAY INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 2, 2018

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

Authorized official

Name
Tiffany Eliopulos
Title
Assistant Manager, Enrollments
Phone
(208) 395-3906

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X 22119 TX Primary

Addresses

Primary practice location

39 Arapaho Village SC
Richardson, TX 75080

Mailing address

250 E Parkcenter Blvd
Boise, ID 83706-3940

Other identifiers 2

IdentifierTypeStateIssuer
4581612OtherOTHER ID NUMBER-COMMERCIAL NUMBER
463772MedicaidTX

Other names 1

  • TOM THUMB PHARMACY #2526 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040819001034 TX Part B Supplier - Centralized Flu Biller 6901703974 This NPI is an additional NPI on the enrollment
Practice locations: Houston, TX
O20100930090642 TX DME Supplier - PharmacyDME Supplier - Grocery Store 6901703974 Practice locations: Richardson, TX

National Provider Directory

National Provider Directory
Part of
Safeway Pharmacy 193

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541116800000",
    "number": "1063448843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 E PARKCENTER BLVD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837063940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 ARAPAHO VILLAGE SC",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "75080",
            "telephone_number": "972-680-9717",
            "fax_number": "972-231-3159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDALLS FOOD & DRUGS LP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAFEWAY INC",
        "enumeration_date": "2006-06-24",
        "last_updated": "2018-11-02",
        "status": "A",
        "authorized_official_last_name": "ELIOPULOS",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "ASSISTANT MANAGER, ENROLLMENTS",
        "authorized_official_telephone_number": "208-395-3906"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "22119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4581612",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "463772",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TOM THUMB PHARMACY #2526",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TOM THUMB PHARMACY #2526",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Richardson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2018; 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.