NPIMap

Organization Active NPI

Ralphs Grocery Company

Doing business as Ralphs Pharmacy

  • Community/Retail Pharmacy
  • Chino, CA
National Provider Identifier
1427073022
Registry record updated Apr 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY47037 Issued in CA
Legal business name
RALPHS GROCERY COMPANY
Doing business as
Ralphs Pharmacy
Practice address
12835 Mountain Ave
Chino, CA 91710-4556
Phone
(909) 548-6366
Fax
(909) 590-4406
NPI assigned
Jul 13, 2006
Last updated
Apr 16, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2014

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

Authorized official

Name
Karla Langworthy
Title
Manager of Pharmacy Credentialing
Phone
(513) 698-1878

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHY47037 CA Primary

Addresses

Primary practice location

12835 Mountain Ave
Chino, CA 91710-4556

Mailing address

1100 W Artesia Blvd
Compton, CA 90220-5108

Other identifiers 2

IdentifierTypeStateIssuer
PHA470370MedicaidCA
2113395OtherPK

Other names 1

  • RALPHS PHARMACY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060502000778 CA Part B Supplier - Mass Immunization (Roster Biller Only) 9133021314 16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Palm Springs, CA; Temecula, CA; Riverside, CA; Rancho Cucamonga, CA; Murrieta, CA; La Quinta, CA; Indio, CA; Fontana, CA…

Other NPIs on the same Medicare enrollment 16

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

View all 16

National Provider Directory

National Provider Directory

Member of 1

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

Locations

12835 Mountain Ave
Chino, CA 91710
Phone (909) 548-6366

1100 W Artesia Blvd
Compton, CA 90220
Phone (310) 884-4728

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": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397606400000",
    "number": "1427073022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 W ARTESIA BLVD",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "902205108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12835 MOUNTAIN AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917104556",
            "telephone_number": "909-548-6366",
            "fax_number": "909-590-4406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALPHS GROCERY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2014-04-16",
        "status": "A",
        "authorized_official_last_name": "LANGWORTHY",
        "authorized_official_first_name": "KARLA",
        "authorized_official_title_or_position": "MANAGER OF PHARMACY CREDENTIALING",
        "authorized_official_telephone_number": "513-698-1878"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY47037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA470370",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2113395",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RALPHS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2014; 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.