Active NPI
RLS Supermarkets LLC
- Community/Retail Pharmacy
- McKinney, TX
National Provider Identifier
1174552137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 29911
- Legal business name
- RLS SUPERMARKETS LLC
- Practice address
- 3001 S Hardin Blvd
McKinney, TX 75070-7736 - Phone
- (972) 547-7110
- Fax
- (972) 547-7114
- NPI assigned
- Jul 2, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- John Piper
- Title
- Director of Pharmacy
- Phone
- (972) 754-4436
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 29911 | TX | Primary |
Addresses
Primary practice location
3001 S Hardin Blvd
McKinney, TX 75070-7736
Mailing address
3001 S Hardin Blvd
McKinney, TX 75070-7736
Phone (972) 547-7110
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 470475 | Medicaid | TX | |
| 2150372 | Other | PK |
Other names 1
- MINYARD PHARMACY #73
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040819001034 | TX | Part B Supplier - Centralized Flu Biller | 6901703974 |
This NPI is an additional NPI on the enrollment Practice locations: Houston, TX |
National Provider Directory
National Provider DirectoryLocations
3001 S Hardin Blvd
McKinney, TX 75070
Phone (469) 678-3680
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151798400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1468886400000",
"number": "1174552137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3001 S HARDIN BLVD",
"city": "MCKINNEY",
"state": "TX",
"postal_code": "750707736",
"telephone_number": "972-547-7110",
"fax_number": "972-547-7114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3001 S HARDIN BLVD",
"city": "MCKINNEY",
"state": "TX",
"postal_code": "750707736",
"telephone_number": "972-547-7110",
"fax_number": "972-547-7114"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RLS SUPERMARKETS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-02",
"last_updated": "2016-07-19",
"status": "A",
"authorized_official_last_name": "PIPER",
"authorized_official_first_name": "JOHN",
"authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
"authorized_official_telephone_number": "972-754-4436"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "TX",
"license": "29911",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "470475",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2150372",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "MINYARD PHARMACY #73",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in McKinney, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2016; 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.