Active NPI
Rosauers Supermarkets Inc
- Community/Retail Pharmacy
- Meridian, ID
National Provider Identifier
1699048009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 18117RP
- Legal business name
- ROSAUERS SUPERMARKETS INC
- Practice address
- 2986 N Eagle Rd
Meridian, ID 83646-6251 - Phone
- (208) 287-9218
- Fax
- (208) 287-9219
- NPI assigned
- Feb 15, 2012
- 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
- Jeffry Philipps, RPH
- Title
- President
- Phone
- (509) 326-8900
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 18117RP | ID | Primary |
Addresses
Primary practice location
2986 N Eagle Rd
Meridian, ID 83646-6251
Mailing address
PO Box 9000
Spokane, WA 99209-9000
Phone (509) 326-8900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2133721 | Other | PK |
Other names 1
- ROSAUERS PHARMACY #41
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111221000241 | ID | Part B Supplier - Mass Immunization (Roster Biller Only) | 9830265131 |
2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Lewiston, ID; Meridian, ID; Moscow, ID |
Other NPIs on the same Medicare enrollment 2
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329264000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1404345600000",
"number": "1699048009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9000",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992099000",
"telephone_number": "509-326-8900",
"fax_number": "509-325-7623"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2986 N EAGLE RD",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836466251",
"telephone_number": "208-287-9218",
"fax_number": "208-287-9219"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ROSAUERS SUPERMARKETS INC",
"organizational_subpart": "NO",
"enumeration_date": "2012-02-15",
"last_updated": "2014-07-03",
"status": "A",
"authorized_official_last_name": "PHILIPPS",
"authorized_official_first_name": "JEFFRY",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "509-326-8900",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "ID",
"license": "18117RP",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2133721",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "ROSAUERS PHARMACY #41",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Meridian, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2014; 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.