Active NPI
RLS Supermarkets LLC
- Community/Retail Pharmacy
- Dallas, TX
National Provider Identifier
1437197894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 29817
- Legal business name
- RLS SUPERMARKETS LLC
- Practice address
- 6464 E Mockingbird LN
Dallas, TX 75214-2406 - Phone
- (214) 827-4230
- Fax
- (214) 823-6294
- NPI assigned
- Jun 4, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ram Maganti
- Title
- Pharmacy Manager
- Phone
- (972) 227-1222
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 29817 | TX | Primary |
Addresses
Primary practice location
6464 E Mockingbird LN
Dallas, TX 75214-2406
Mailing address
6464 E Mockingbird LN
Dallas, TX 75214-2406
Phone (214) 827-4230
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 470468 | Medicaid | TX | |
| 2150141 | Other | PK | |
| 463372 | Medicaid | TX |
Other names 1
- MINYARD PHARMACY #32
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041014000405 | TX | Part B Supplier - Centralized Flu Biller | 8729983515 |
This NPI is an additional NPI on the enrollment Practice locations: Boise, ID |
National Provider Directory
National Provider DirectoryMember of 3
Organizations this organization is a member of, according to the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149379200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1480550400000",
"number": "1437197894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6464 E MOCKINGBIRD LN",
"city": "DALLAS",
"state": "TX",
"postal_code": "752142406",
"telephone_number": "214-827-4230",
"fax_number": "214-823-6294"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6464 E MOCKINGBIRD LN",
"city": "DALLAS",
"state": "TX",
"postal_code": "752142406",
"telephone_number": "214-827-4230",
"fax_number": "214-823-6294"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RLS SUPERMARKETS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-04",
"last_updated": "2016-12-01",
"status": "A",
"authorized_official_last_name": "MAGANTI",
"authorized_official_first_name": "RAM",
"authorized_official_title_or_position": "PHARMACY MANAGER",
"authorized_official_telephone_number": "972-227-1222"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "TX",
"license": "29817",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "470468",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2150141",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "463372",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "MINYARD PHARMACY #32",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2016; 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.