Raley'S

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

RALEY'S

Practice address

4690 Freeport Blvd
Sacramento, CA 95822

Phone

(916) 452-3811

NPI assigned

Apr 3, 2020

Organization subpart

No

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

Authorized official

Name

Alisha Reynoso

Title

Pharmacy Operations Analyst

Phone

(916) 376-6687

Specialties & licenses 1

Addresses

Other names 1

• Raley's Pharmacy #415 Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

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

{
    "created_epoch": "1585872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585872000000",
    "number": "1225667181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4690 FREEPORT BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95822",
            "telephone_number": "916-452-3811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4690 FREEPORT BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95822",
            "telephone_number": "916-452-3811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALEY'S",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-03",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A",
        "authorized_official_last_name": "REYNOSO",
        "authorized_official_first_name": "ALISHA",
        "authorized_official_title_or_position": "PHARMACY OPERATIONS ANALYST",
        "authorized_official_telephone_number": "916-376-6687"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Raley's Pharmacy #415",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rajech Chunduri DMD PC
• Apoorva Thimma Raju, MD
• Shravya Raju
• Tanuja R. Raju, M.D.
• Taufiq Rajwani, DO
• Raleys
• Raleys
• Raleys
• Raleys
• Tina Marie Rallhan

• Community/Retail Pharmacy in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; 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.