Active NPI
RLS Supermarkets LLC
- Community/Retail Pharmacy
- Dallas, TX
National Provider Identifier
1497792949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 29818
- Legal business name
- RLS SUPERMARKETS LLC
- Practice address
- 3524 McKinney Ave
Dallas, TX 75204-1402 - Phone
- (214) 528-0516
- Fax
- (214) 526-8215
- NPI assigned
- Jun 1, 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
- John Piper
- Title
- Director of Pharmacy
- Phone
- (972) 227-1222
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 29818 | TX | Primary |
Addresses
Primary practice location
3524 McKinney Ave
Dallas, TX 75204-1402
Mailing address
3524 McKinney Ave
Dallas, TX 75204-1402
Phone (214) 526-8215
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 463603 | Medicaid | TX | |
| 2150194 | Other | PK | |
| 470474 | Medicaid | TX |
Other names 1
- MINYARD PHARMACY #68
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": "1149120000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1468886400000",
"number": "1497792949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3524 MCKINNEY AVE",
"city": "DALLAS",
"state": "TX",
"postal_code": "752041402",
"telephone_number": "214-526-8215",
"fax_number": "214-526-8215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3524 MCKINNEY AVE",
"city": "DALLAS",
"state": "TX",
"postal_code": "752041402",
"telephone_number": "214-528-0516",
"fax_number": "214-526-8215"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RLS SUPERMARKETS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-01",
"last_updated": "2016-07-19",
"status": "A",
"authorized_official_last_name": "PIPER",
"authorized_official_first_name": "JOHN",
"authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
"authorized_official_telephone_number": "972-227-1222"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "TX",
"license": "29818",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "463603",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2150194",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "470474",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "MINYARD PHARMACY #68",
"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 Jul 19, 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.