NPIMap

Organization Active NPI

Rosauers Supermarkets, Inc.

Doing business as Rosauers Pharmacy 36

  • Community/Retail Pharmacy
  • Walla Walla, WA
National Provider Identifier
1184510711
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
ROSAUERS SUPERMARKETS, INC.
Doing business as
Rosauers Pharmacy 36
Practice address
710 S 9TH Ave
Walla Walla, WA 99362-3906
Phone
(509) 525-8790
NPI assigned
Jun 18, 2025
Last updated
Jun 25, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Authorized official

Name
Mr. Robert William Queen, R.PH.
Title
Director of Pharmacy
Phone
(509) 326-8900

Specialties & licenses 1

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

Addresses

Primary practice location

710 S 9TH Ave
Walla Walla, WA 99362-3906

Mailing address

710 S 9TH Ave
Walla Walla, WA 99362-3906
Phone (509) 525-8790

Other names 1

  • Rosauers Pharmacy 36 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260605001416 WA DME Supplier - PharmacyDME Supplier - Grocery Store 9830265131 Practice locations: Walla Walla, WA

Other NPIs with the same Medicare PAC ID 16

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 16

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Rosauers Pharmacy #36710 S 9TH Ave, Walla Walla, WA 99362-3906(509) 516-4211 Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs Accepts assignmentParticipating since Oct 25, 2011

National Provider Directory

National Provider Directory
Tax ID family
Rosauers Pharmacy 1020 organizations share this tax ID, including this one

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

Member of 1

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

Locations

710 S 9th Ave
Walla Walla, WA 99362
Phone (509) 525-8790

NPI Registry JSON

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

{
    "created_epoch": "1750204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750809600000",
    "number": "1184510711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 S 9TH AVE",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993623906",
            "telephone_number": "509-525-8790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 S 9TH AVE",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993623906",
            "telephone_number": "509-525-8790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSAUERS SUPERMARKETS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-18",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A",
        "authorized_official_last_name": "QUEEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "509-326-8900",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rosauers Pharmacy 36",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Walla Walla, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.