Active NPI
Riser Foods Company
- Community/Retail Pharmacy
- Wickliffe, OH
National Provider Identifier
1497760318
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- RISER FOODS COMPANY
- Practice address
- 27505 Chardon Rd
Wickliffe, OH 44092-2794 - Phone
- (440) 944-9387
- Fax
- (440) 944-9391
- NPI assigned
- Jul 29, 2006
- Organization subpart
- Yes
- Parent organization
- GIANT EAGLE INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Debra Krasnow
- Title
- Director Managed Care
- Phone
- (412) 968-1550
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 21223950 | OH | |
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
27505 Chardon Rd
Wickliffe, OH 44092-2794
Mailing address
101 Kappa Dr
Pittsburgh, PA 15238-2809
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3668413 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER | |
| P00419119 | Other | OH | MEDICARE RAILROAD FLU RISER OHIO |
| 2194923 | Medicaid | OH |
Other names 1
- GIANT EAGLE PHARMACY 1225
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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… |
National Provider Directory
National Provider Directory- Part of
- Giant Eagle Pharm 2486
Member of 1
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": "1154131200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1241568000000",
"number": "1497760318",
"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"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27505 CHARDON RD",
"city": "WICKLIFFE",
"state": "OH",
"postal_code": "440922794",
"telephone_number": "440-944-9387",
"fax_number": "440-944-9391"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RISER FOODS COMPANY",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "GIANT EAGLE INC",
"enumeration_date": "2006-07-29",
"last_updated": "2009-05-06",
"status": "A",
"authorized_official_last_name": "KRASNOW",
"authorized_official_first_name": "DEBRA",
"authorized_official_title_or_position": "DIRECTOR MANAGED CARE",
"authorized_official_telephone_number": "412-968-1550"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "OH",
"license": "21223950",
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "3668413",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD FLU RISER OHIO",
"identifier": "P00419119",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2194923",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "GIANT EAGLE PHARMACY 1225",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Wickliffe, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2009; 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.