NPIMap

Organization Active NPI

Raleys

  • Community/Retail Pharmacy
  • Modesto, CA
National Provider Identifier
1396944872
Registry record updated Jun 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY53520 Issued in CA
Legal business name
RALEYS
Practice address
3020 Floyd Ave
Modesto, CA 95355-9604
Phone
(209) 551-6030
NPI assigned
Jul 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2015

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

Authorized official

Name
Helen S Singmaster
Title
Secretary
Phone
(916) 373-6394

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHY53520 CA Primary

Addresses

Primary practice location

3020 Floyd Ave
Modesto, CA 95355-9604

Mailing address

500 West Capitol Ave.
West Sacramento, CA 95605-2696
Phone (916) 373-6394

Other identifiers 2

IdentifierTypeStateIssuer
1396944872MedicaidCA
5627712OtherNCPDP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040831000246 CA Part B Supplier - Mass Immunization (Roster Biller Only) 2365417722 This NPI is an additional NPI on the enrollment
Practice locations: Sacramento, CA; Petaluma, CA; S Lake Tahoe, CA; Rohnert Park, CA; Rohnert, CA; Redding, CA; Red Bluff, CA; Pleasanton, CA…
O20081120000206 CA Part B Supplier - Mass Immunization (Roster Biller Only) 2365417722 12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: West Sacramento, CA; Sacramento, CA; Modesto, CA; Galt, CA; Citrus Heights, CA; Loomis, CA; Auburn, CA; Carmichael, CA
O20100930030007 CA DME Supplier - PharmacyDME Supplier - Grocery Store 2365417722 Practice locations: Modesto, CA

Other NPIs on the same Medicare enrollment 6

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

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Raley's Pharmacy #3393020 Floyd Ave, Modesto, CA 95355-9604(209) 551-6030 Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) Does not accept assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
Raleys Drug Ctr 49252 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 2

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": "1184284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433721600000",
    "number": "1396944872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 WEST CAPITOL AVE.",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956052696",
            "telephone_number": "916-373-6394",
            "fax_number": "916-372-6226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 FLOYD AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953559604",
            "telephone_number": "209-551-6030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALEYS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-13",
        "last_updated": "2015-06-08",
        "status": "A",
        "authorized_official_last_name": "SINGMASTER",
        "authorized_official_first_name": "HELEN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "916-373-6394"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY53520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396944872",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "5627712",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; 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.