NPIMap

Organization Active NPI

Randalls Food & Drugs LP

Doing business as Randalls Pharmacy #1896

  • Community/Retail Pharmacy
  • Cedar Park, TX
National Provider Identifier
1356387971
Registry record updated Jul 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
RANDALLS FOOD & DRUGS LP
Doing business as
Randalls Pharmacy #1896
Practice address
1400 Cypress Creek Rd
Cedar Park, TX 78613-4471
Phone
(512) 506-9112
Fax
(512) 506-9127
NPI assigned
Jun 21, 2006
Last updated
Jul 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2024

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

Authorized official

Name
Kathy Giannakopoulos
Title
Enrollments Manager
Phone
(208) 395-3954

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Pharmacy 333600000X 21279 TX
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

1400 Cypress Creek Rd
Cedar Park, TX 78613-4471

Mailing address

250 E Parkcenter Blvd
Boise, ID 83706-3940

Other identifiers 2

IdentifierTypeStateIssuer
4520424OtherOTHER ID NUMBER-COMMERCIAL NUMBER
465113MedicaidTX

Other names 1

  • RANDALLS PHARMACY #1896 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040819001034 TX Part B Supplier - Centralized Flu Biller 6901703974 This NPI is an additional NPI on the enrollment
Practice locations: Houston, TX
O20100930042580 TX DME Supplier - PharmacyDME Supplier - Grocery Store 6901703974 Practice locations: Cedar Park, TX

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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2247518Randalls Pharmacy #18961400 Cypress Creek Rd, Cedar Park, TX 78613Certificate of waiverJan 5, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Randalls Pharmacy #18961400 Cypress Creek Rd, Cedar Park, TX 78613-3605(512) 506-9112 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Orthoses: Off-The-Shelf|Ostomy Supplies|Urological Supplies|Surgical Dressings Does not accept assignmentParticipating since Jan 1, 2017

National Provider Directory

National Provider Directory

Member of 1

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

  • Safeway Inc

    dba Safeway Phamracy #4837

    • Community/Retail Pharmacy
    • District Heights, MD
    • NPI 1588600191

    Member Of

    NPD member

Member organizations 754

Organizations listed as members of this organization in the National Provider Directory.

View all 754

Locations

1400 Cypress Creek Rd
Cedar Park, TX 78613
Phone (512) 506-9112

Practitioners & affiliated clinicians

Practitioners 4

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": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720137600000",
    "number": "1356387971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 E PARKCENTER BLVD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837063940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 CYPRESS CREEK RD",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786134471",
            "telephone_number": "512-506-9112",
            "fax_number": "512-506-9127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDALLS FOOD & DRUGS LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2024-07-05",
        "certification_date": "2024-07-05",
        "status": "A",
        "authorized_official_last_name": "GIANNAKOPOULOS",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "ENROLLMENTS MANAGER",
        "authorized_official_telephone_number": "208-395-3954"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TX",
            "license": "21279",
            "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": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4520424",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "465113",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RANDALLS PHARMACY #1896",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "RANDALLS PHARMACY #1896",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cedar Park, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2024; 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.