NPIMap

Organization Active NPI

Raley'S Arizona LLC

  • Community/Retail Pharmacy
  • Gilbert, AZ
National Provider Identifier
1619179983
Registry record updated Apr 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
RALEY'S ARIZONA LLC
Doing business as
Bashas' United Drug 172
Practice address
99 S Higley Rd
Gilbert, AZ 85296-1168
Phone
(480) 926-5221
Fax
(480) 926-5223
NPI assigned
May 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2022

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

Authorized official

Name
Mike McKinley
Title
Director of Pharmacy
Phone
(480) 895-5372

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Y004757 AZ
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

99 S Higley Rd
Gilbert, AZ 85296-1168

Mailing address

PO Box 488
Chandler, AZ 85244-0488
Phone (480) 895-5370

Other identifiers 2

IdentifierTypeStateIssuer
0354744OtherAZNCPDP
211736MedicaidAZ

Other names 1

  • Bashas' United Drug 172 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230308001395 AZ Part B Supplier - Pharmacy 0840663050 37 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Queen Creek, AZ; Scottsdale, AZ; Sedona, AZ; Sierra Vista, AZ; Sun City West, AZ; Sun Lakes, AZ; Surprise, AZ; Tempe, AZ…

Other NPIs on the same Medicare enrollment 37

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

View all 37

National Provider Directory

National Provider Directory
Tax ID family
Bashas39 organizations share this tax ID, including this one

Other organizations with this tax ID 38

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

View all 38

Locations

1300 N San Antonio Ave
Douglas, AZ 85607
Phone (520) 364-3770

21044 N John Wayne Pkwy
Maricopa, AZ 85139
Phone (520) 836-4401

1133 N Ellsworth Rd
Mesa, AZ 85207
Phone (480) 984-3431

5555 N 7th St
Ste 130
Phoenix, AZ 85014
Phone (602) 277-6133

3442 W Van Buren St
Phoenix, AZ 85009
Phone (602) 278-8831

23760 S Power Rd
Queen Creek, AZ 85142
Phone (480) 279-5701

8035 E Indian School Rd
Scottsdale, AZ 85251
Phone (480) 663-1043

85 S Highway 92
Sierra Vista, AZ 85635
Phone (520) 439-6081

10325 E Riggs Rd
Sun Lakes, AZ 85248
Phone (480) 802-7182

15367 W Waddell Rd
Surprise, AZ 85379
Phone (623) 214-6461

2000 W River Rd
Tucson, AZ 85704
Phone (520) 690-3681

8360 N Thornydale Rd
Tucson, AZ 85741
Phone (520) 744-1370

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649980800000",
    "number": "1619179983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 488",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852440488",
            "telephone_number": "480-895-5370",
            "fax_number": "480-895-5371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 S HIGLEY RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852961168",
            "telephone_number": "480-926-5221",
            "fax_number": "480-926-5223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALEY'S ARIZONA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-31",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A",
        "authorized_official_last_name": "MCKINLEY",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "480-895-5372"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AZ",
            "license": "Y004757",
            "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": "NCPDP",
            "identifier": "0354744",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "211736",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bashas' United Drug 172",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2022; 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.