Active NPI
Ralphs Grocery Company
- Community/Retail Pharmacy
- San Diego, CA
National Provider Identifier
1629086830
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PHY48204
- Legal business name
- RALPHS GROCERY COMPANY
- Practice address
- 3345 Sports Arena Blvd
San Diego, CA 92110-4567 - Phone
- (619) 225-1631
- Fax
- (619) 225-1642
- NPI assigned
- Aug 3, 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
- Allison Muennich
- Title
- Manager of Pharmacy Licensing
- Phone
- (513) 762-1019
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Community/Retail Pharmacy | 3336C0003X | PHY48204 | CA | Primary |
Addresses
Primary practice location
3345 Sports Arena Blvd
San Diego, CA 92110-4567
Mailing address
PO Box 842772
Boston, MA 02284-2772
Phone (513) 762-1019
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2115039 | Other | PK |
Other names 1
- RALPHS PHARMACY
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090408000203 | CA | Part B Supplier - Mass Immunization (Roster Biller Only) | 9133021314 | This NPI is an additional NPI on the enrollment |
| O20100930073435 | CA | DME Supplier - Pharmacy | 9133021314 | Practice locations: San Diego, CA |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2003009 | Ralphs Pharmacy #201 | Certificate of waiver | Jan 28, 2028 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Ralphs Pharmacy #201 | Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Canes and/or Crutches|Walkers|Ostomy Supplies|Urological Supplies|Enteral Nutrients|Enteral Equipment and/or Supplies|Nebulizer Equipment a… | Accepts assignment |
National Provider Directory
National Provider Directory- Tax ID family
- Ralphs Grocery Company
Organizations with this tax ID in the same state 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- Community/Retail Pharmacy
- Fullerton, CA
- NPI 1477578078
-
- Community/Retail Pharmacy
- Pasadena, CA
- NPI 1497949275
-
- Community/Retail Pharmacy
- Oceanside, CA
- NPI 1518982115
-
- Community/Retail Pharmacy
- Newbury Park, CA
- NPI 1528083128
-
- Community/Retail Pharmacy
- Palos Verdes Estates, CA
- NPI 1538184130
-
- Community/Retail Pharmacy
- West Hollywood, CA
- NPI 1538363585
-
- Community/Retail Pharmacy
- San Francisco, CA
- NPI 1568487163
-
- Community/Retail Pharmacy
- Santa Monica, CA
- NPI 1578588174
-
- Community/Retail Pharmacy
- West Hollywood, CA
- NPI 1588689186
-
- Community/Retail Pharmacy
- Lake Forest, CA
- NPI 1598822843
-
- Community/Retail Pharmacy
- Pasadena, CA
- NPI 1609891209
-
- Community/Retail Pharmacy
- Palm Springs, CA
- NPI 1619992211
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
3345 Sports Arena Blvd
San Diego, CA 92110
Phone (619) 222-5818
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154563200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1463356800000",
"number": "1629086830",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 842772",
"city": "BOSTON",
"state": "MA",
"postal_code": "022842772",
"telephone_number": "513-762-1019",
"fax_number": "513-762-1092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3345 SPORTS ARENA BLVD",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921104567",
"telephone_number": "619-225-1631",
"fax_number": "619-225-1642"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RALPHS GROCERY COMPANY",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-03",
"last_updated": "2016-05-16",
"status": "A",
"authorized_official_last_name": "MUENNICH",
"authorized_official_first_name": "ALLISON",
"authorized_official_title_or_position": "MANAGER OF PHARMACY LICENSING",
"authorized_official_telephone_number": "513-762-1019"
},
"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": "CA",
"license": "PHY48204",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2115039",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "RALPHS PHARMACY",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.