NPIMap

Organization Active NPI

Rosauers Supermarkets, Inc.

Doing business as Rosauers Pharmacy #3

  • Community/Retail Pharmacy
  • Spokane Valley, WA
National Provider Identifier
1568575892
Registry record updated Feb 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
262010403850 Issued in WA
Legal business name
ROSAUERS SUPERMARKETS, INC.
Doing business as
Rosauers Pharmacy #3
Practice address
10618 E Sprague Ave
Spokane Valley, WA 99206-3632
Phone
(509) 924-5560
Fax
(509) 927-8518
NPI assigned
Aug 17, 2006
Last updated
Feb 1, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2008

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

Authorized official

Name
Mr. Glen M. Stocking, R.PH.
Title
Director of Pharmacy
Phone
(509) 326-8900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 262010403850 WA Primary

Addresses

Primary practice location

10618 E Sprague Ave
Spokane Valley, WA 99206-3632

Mailing address

10618 E Sprague Ave
Spokane Valley, WA 99206-3632
Phone (509) 924-5560

Other identifiers 1

IdentifierTypeStateIssuer
6171706MedicaidWA

Other names 1

  • Rosauers Pharmacy #3 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080911000092 WA Part B Supplier - Mass Immunization (Roster Biller Only) 9830265131 9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Spokane, WA; Yakima, WA; Spokane Valley, WA; Ridgefield, WA; Ellensburg, WA; Colville, WA
O20100930065113 WA DME Supplier - PharmacyDME Supplier - Grocery Store 9830265131 Practice locations: Spokane Valley, WA

Other NPIs with the same Medicare PAC ID 16

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 16

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Rosauers Pharmacy 1020 organizations share this tax ID, including this one

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201824000000",
    "number": "1568575892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10618 E SPRAGUE AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992063632",
            "telephone_number": "509-924-5560",
            "fax_number": "509-927-8518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10618 E SPRAGUE AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992063632",
            "telephone_number": "509-924-5560",
            "fax_number": "509-927-8518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSAUERS SUPERMARKETS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2008-02-01",
        "status": "A",
        "authorized_official_last_name": "STOCKING",
        "authorized_official_first_name": "GLEN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "509-326-8900",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "262010403850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6171706",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rosauers Pharmacy #3",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spokane Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2008; 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.