Organization Active NPI

Randalls Food & Drugs LP

  • Community/Retail Pharmacy
  • Frisco, TX
National Provider Identifier
1366488983
Registry record updated Nov 2, 2018
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
TOM THUMB PHARMACY #2581
Practice address
4848 Preston Rd
Frisco, TX 75034-8522
Phone
(972) 377-1812
Fax
(972) 377-1817
NPI assigned
Jun 21, 2006
Organization subpart
Yes
Parent organization
SAFEWAY INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 2, 2018

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

Authorized official

Name
Tiffany Eliopulos
Title
Assistant Manager, Enrollments
Phone
(208) 395-3906

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 22177 TX
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

4848 Preston Rd
Frisco, TX 75034-8522

Mailing address

250 E Parkcenter Blvd
Boise, ID 83706-3940

Other identifiers 2

IdentifierTypeStateIssuer
4509230OtherOTHER ID NUMBER-COMMERCIAL NUMBER
464310MedicaidTX

Other names 1

  • TOM THUMB PHARMACY #2581 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
O20100930015103 TX DME Supplier - PharmacyDME Supplier - Grocery Store 6901703974 Practice locations: Frisco, TX

National Provider Directory

National Provider Directory
Part of
Safeway Pharmacy 1073

Member of 1

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

Locations

4848 Preston Rd
Frisco, TX 75034
Phone (972) 377-1812

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": "1541116800000",
    "number": "1366488983",
    "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": "4848 PRESTON RD",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750348522",
            "telephone_number": "972-377-1812",
            "fax_number": "972-377-1817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDALLS FOOD & DRUGS LP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAFEWAY INC",
        "enumeration_date": "2006-06-21",
        "last_updated": "2018-11-02",
        "status": "A",
        "authorized_official_last_name": "ELIOPULOS",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "ASSISTANT MANAGER, ENROLLMENTS",
        "authorized_official_telephone_number": "208-395-3906"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "22177",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4509230",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "464310",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TOM THUMB PHARMACY #2581",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TOM THUMB PHARMACY #2581",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Frisco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2018; 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.