Organization Active NPI

Riser Foods Company

Doing business as Giant Eagle Pharmacy #5874

  • Community/Retail Pharmacy
  • Cleveland, OH
National Provider Identifier
1346397791
Registry record updated Apr 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
02-1643450 Issued in OH
Legal business name
RISER FOODS COMPANY
Doing business as
Giant Eagle Pharmacy #5874
Practice address
10950 Lorain Ave
Cleveland, OH 44111-5417
Phone
(216) 251-5518
Fax
(216) 671-8173
NPI assigned
Jan 5, 2007
Last updated
Apr 16, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
GIANT EAGLE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 16, 2009

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

Authorized official

Name
Ms. Debra B. Krasnow, PHARM DNPI 1821286717
Title
Director of Managed Care
Phone
(412) 968-1550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 02-1643450 OH Primary

Addresses

Primary practice location

10950 Lorain Ave
Cleveland, OH 44111-5417

Mailing address

101 Kappa Dr
Pittsburgh, PA 15238-2809
Phone (412) 968-1550

Other identifiers 1

IdentifierTypeStateIssuer
2721139MedicaidOH

Other names 1

  • Giant Eagle Pharmacy #5874 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040622001601 OH Part B Supplier - Mass Immunization (Roster Biller Only) 5193700292 This NPI is an additional NPI on the enrollment
Practice locations: Medina, OH; Mentor, OH; Mentor on the Lake, OH; Middlburg, OH; Middlefield, OH; North Olmsted, OH; North Ridgeville, OH; North Royalton, OH…

National Provider Directory

National Provider Directory
Part of
Giant Eagle Pharm 4

Locations

10950 Lorain Ave
Cleveland, OH 44111
Phone (216) 251-5518

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239840000000",
    "number": "1346397791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 KAPPA DR",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152382809",
            "telephone_number": "412-968-1550",
            "fax_number": "412-968-1727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10950 LORAIN AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441115417",
            "telephone_number": "216-251-5518",
            "fax_number": "216-671-8173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RISER FOODS COMPANY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GIANT EAGLE INC",
        "enumeration_date": "2007-01-05",
        "last_updated": "2009-04-16",
        "status": "A",
        "authorized_official_last_name": "KRASNOW",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "DIRECTOR OF MANAGED CARE",
        "authorized_official_telephone_number": "412-968-1550",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "02-1643450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2721139",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Giant Eagle Pharmacy #5874",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2009; 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.