NPIMap

Organization Active NPI

Riser Foods Company

Doing business as Giant Eagle Pharmacy #0230

  • Community/Retail Pharmacy
  • Cleveland, OH
National Provider Identifier
1447408083
Registry record updated May 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
021899900 Issued in OH
Legal business name
RISER FOODS COMPANY
Doing business as
Giant Eagle Pharmacy #0230
Practice address
3050 W. 117TH St.
Cleveland, OH 44111-1645
Phone
(412) 251-5518
Fax
(216) 671-8173
NPI assigned
Sep 8, 2008
Last updated
May 12, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
GIANT EAGLE, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 12, 2009

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

Authorized official

Name
Ms. Debra B. Krasnow, PHARMADNPI 1821286717
Title
Director of Managed Care
Phone
(412) 968-1550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 021899900 OH Primary

Addresses

Primary practice location

3050 W. 117TH St.
Cleveland, OH 44111-1645

Mailing address

101 Kappa Dr
Pittsburgh, PA 15238-2809
Phone (412) 968-1550

Other identifiers 2

IdentifierTypeStateIssuer
2858215MedicaidOH
P00419119OtherOHMEDICARE RAILROAD FLU RISER OHIO

Other names 1

  • Giant Eagle Pharmacy #0230 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040622001601 OH Part B Supplier - Mass Immunization (Roster Biller Only) 5193700292 This NPI is an additional NPI on the enrollment
Practice locations: Medina, OH; Mentor, OH; Mentor on the Lake, OH; Middlburg, OH; Middlefield, OH; North Olmsted, OH; North Ridgeville, OH; North Royalton, OH…
O20100930044434 OH DME Supplier - PharmacyDME Supplier - Grocery Store 5193700292 Practice locations: Cleveland, OH

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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2188338Giant Eagle Pharmacy #02303050 W 117TH St, Cleveland, OH 44111Certificate of waiverJul 15, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Giant Eagle Pharmacy #02303050 W 117TH St, Cleveland, OH 44111-1645(216) 941-5109 Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Canes and/or Crutches|Ostomy Supplies|Nebulizer Equipment and/or Supplies|Surgical Dressings Does not accept assignmentParticipating since Jan 1, 2016

National Provider Directory

National Provider Directory
Tax ID family
Riser Foods Company51 organizations share this tax ID, including this one
Part of
Giant Eagle Pharm 61

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

Member of 1

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

Locations

3050 W 117th St
Cleveland, OH 44111
Phone (216) 941-5109

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": "1220832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242086400000",
    "number": "1447408083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 KAPPA DR",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152382809",
            "telephone_number": "412-968-1550",
            "fax_number": "412-967-1727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 W. 117TH ST.",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441111645",
            "telephone_number": "412-251-5518",
            "fax_number": "216-671-8173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RISER FOODS COMPANY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GIANT EAGLE, INC",
        "enumeration_date": "2008-09-08",
        "last_updated": "2009-05-12",
        "status": "A",
        "authorized_official_last_name": "KRASNOW",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "DIRECTOR OF MANAGED CARE",
        "authorized_official_telephone_number": "412-968-1550",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PHARMAD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "021899900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2858215",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD FLU RISER OHIO",
            "identifier": "P00419119",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Giant Eagle Pharmacy #0230",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2009; 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.