Randalls Food & Drugs LP

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

RANDALLS FOOD & DRUGS LP

Doing business as

Tom Thumb Pharmacy #2609

Practice address

612 Grapevine Hwy
Hurst, TX 76054-2758

Phone

(817) 281-0456

Fax

(817) 281-0489

NPI assigned

Jun 21, 2006

Last updated

Oct 4, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

SAFEWAY INCAs reported in NPPES

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

Authorized official

Name

Tiffany Eliopulos

Title

Assistant Manager, Enrollments

Phone

(208) 395-3906

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• TOM THUMB PHARMACY #2609 Doing business as

Medicare fee-for-service enrollment

Enrolled in TX2 enrollments

Enrollment records 2

Part of

Safeway Pharmacy 193

Member of 1

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

• Safeway Inc

  dba Safeway Pharmacy #3525

  • Community/Retail Pharmacy
  • Chehalis, WA
  • NPI 1285663203

  Member Of

  NPD member

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538611200000",
    "number": "1508802380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 E PARKCENTER BLVD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837063940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 GRAPEVINE HWY",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760542758",
            "telephone_number": "817-281-0456",
            "fax_number": "817-281-0489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDALLS FOOD & DRUGS LP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAFEWAY INC",
        "enumeration_date": "2006-06-21",
        "last_updated": "2018-10-04",
        "status": "A",
        "authorized_official_last_name": "ELIOPULOS",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "ASSISTANT MANAGER, ENROLLMENTS",
        "authorized_official_telephone_number": "208-395-3906"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "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": "4557116",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "463756",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TOM THUMB PHARMACY #2609",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TOM THUMB PHARMACY #2609",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Farhana Rahman
• Adam Raiford, PTA
• Dina Ramirez, OTA
• Jeanie Stuart Rance-Marr, LMT, NCMMT
• Randall E Wonderlich DC (Wonderlich Chiropractic)
• Isabella Randolph
• Brian D Ranelle, D.O.
• Ranganath Habbu, M.D.,PA
• Recovery Communities of Culture
• Raghuram M Reddy, M.D.

• Community/Retail Pharmacy in Hurst, TX
• Providers in Hurst, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2018; 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.

Verify at the official NPI Registry.