NPIMap

Organization Active NPI

Raley's Arizona LLC

Doing business as Food City

  • Community/Retail Pharmacy
  • Sierra Vista, AZ
National Provider Identifier
1184736167
Registry record updated Apr 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
RALEY'S ARIZONA LLC
Doing business as
Food City
Food City United Drug 111
Practice address
85 S Hwy 92
Sierra Vista, AZ 85635-3637
Phone
(520) 439-6081
Fax
(520) 439-6083
NPI assigned
Aug 31, 2006
Last updated
Apr 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2022

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

Authorized official

Name
Mike McKinley
Title
Director of Pharmacy
Phone
(480) 895-5372

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X Y003390 AZ
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

85 S Hwy 92
Sierra Vista, AZ 85635-3637

Mailing address

85 S Hwy 92
Sierra Vista, AZ 85635-3637
Phone (520) 439-6081

Other identifiers 2

IdentifierTypeStateIssuer
0326290OtherNCPDP PROVIDER IDENTIFICATION NUMBER
638182MedicaidAZ

Other names 2

  • FOOD CITY Doing business as
  • Food City United Drug 111 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230308001395 AZ Part B Supplier - Pharmacy 0840663050 37 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Queen Creek, AZ; Scottsdale, AZ; Sedona, AZ; Sierra Vista, AZ; Sun City West, AZ; Sun Lakes, AZ; Surprise, AZ; Tempe, AZ…

Other NPIs on the same Medicare enrollment 37

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 37

National Provider Directory

National Provider Directory
Tax ID family
Bashas39 organizations share this tax ID, including this one

Other organizations with this tax ID 38

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

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649980800000",
    "number": "1184736167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 S HWY 92",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856353637",
            "telephone_number": "520-439-6081",
            "fax_number": "520-439-6083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 S HWY 92",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856353637",
            "telephone_number": "520-439-6081",
            "fax_number": "520-439-6083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALEY'S ARIZONA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A",
        "authorized_official_last_name": "MCKINLEY",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "480-895-5372"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AZ",
            "license": "Y003390",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0326290",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "638182",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FOOD CITY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Food City United Drug 111",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sierra Vista, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2022; 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.