Organization Active NPI

Riser Foods Company

  • Community/Retail Pharmacy
  • Westlake, OH
National Provider Identifier
1689689507
Registry record updated May 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
021212400 Issued in OH
Legal business name
RISER FOODS COMPANY
Practice address
30275 Detroit Rd
Westlake, OH 44145-1948
Phone
(440) 871-5710
Fax
(440) 871-8014
NPI assigned
Jul 29, 2006
Organization subpart
Yes
Parent organization
GIANT EAGLE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 20, 2009

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

Authorized official

Name
Debra Krasnow
Title
Director Managed Care
Phone
(412) 968-1550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 021212400 OH Primary

Addresses

Primary practice location

30275 Detroit Rd
Westlake, OH 44145-1948

Mailing address

101 Kappa Dr
Pittsburgh, PA 15238-2809

Other identifiers 3

IdentifierTypeStateIssuer
2210048MedicaidOH
P00419119OtherOHRRB
3668401OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • GIANT EAGLE PHARMACY 1216 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040622001601 OH Part B Supplier - Mass Immunization (Roster Biller Only) 5193700292 This NPI is an additional NPI on the enrollment
Practice locations: Medina, OH; Mentor, OH; Mentor on the Lake, OH; Middlburg, OH; Middlefield, OH; North Olmsted, OH; North Ridgeville, OH; North Royalton, OH…
O20100930091392 OH DME Supplier - PharmacyDME Supplier - Grocery Store 5193700292 Practice locations: Westlake, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Riser Foods Company30275 Detroit Rd, Westlake, OH 44145-1948(440) 871-5710 Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Canes and/or Crutches|Ostomy Supplies|Nebulizer Equipment and/or Supplies|Surgical Dressings Does not accept assignmentParticipating since Jan 1, 2016

National Provider Directory

National Provider Directory
Tax ID family
Giant Eagle Pharmacy 408651 organizations share this tax ID, including this one
Part of
Giant Eagle Pharm 2486

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.

View all 24

Member of 1

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

Locations

30275 Detroit Rd
Westlake, OH 44145
Phone (440) 871-5710

Practitioners & affiliated clinicians

Practitioners 2

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": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242777600000",
    "number": "1689689507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 KAPPA DR",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152382809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30275 DETROIT RD",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441451948",
            "telephone_number": "440-871-5710",
            "fax_number": "440-871-8014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RISER FOODS COMPANY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GIANT EAGLE INC",
        "enumeration_date": "2006-07-29",
        "last_updated": "2009-05-20",
        "status": "A",
        "authorized_official_last_name": "KRASNOW",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "DIRECTOR MANAGED CARE",
        "authorized_official_telephone_number": "412-968-1550"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "021212400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2210048",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRB",
            "identifier": "P00419119",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3668401",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GIANT EAGLE PHARMACY 1216",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Westlake, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2009; 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.

Verify at the official NPI Registry.