Active NPI
Raleys
- Community/Retail Pharmacy
- Fair Oaks, CA
National Provider Identifier
1437269180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PHY53530
- Legal business name
- RALEYS
- Practice address
- 4840 San Juan Ave
Fair Oaks, CA 95628-4719 - Phone
- (916) 966-2266
- NPI assigned
- Aug 30, 2006
- Last updated
- Jun 4, 2015
- 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
- Helen S Singmaster
- Title
- Secretary
- Phone
- (916) 373-6394
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | PHY53530 | CA | Primary |
Addresses
Primary practice location
4840 San Juan Ave
Fair Oaks, CA 95628-4719
Mailing address
500 West Capitol Ave.
West Sacramento, CA 95605-2696
Phone (916) 373-6394
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0505416 | Other | NABP | |
| 1437269180 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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… |
National Provider Directory
National Provider DirectoryPractitioners & 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.
-
- Pharmacist
- Fair Oaks, CA
- NPI 1164834156
-
- Pharmacist
- Fair Oaks, CA
- NPI 1528455342
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1433376000000",
"number": "1437269180",
"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": "4840 SAN JUAN AVE",
"city": "FAIR OAKS",
"state": "CA",
"postal_code": "956284719",
"telephone_number": "916-966-2266"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RALEYS",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-30",
"last_updated": "2015-06-04",
"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": "PHY53530",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NABP",
"identifier": "0505416",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1437269180",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fair Oaks, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2015; 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.