NPIMap

Organization Active NPI

Rosauers Supermarkets Inc

Doing business as Rosauers Pharmacy

  • Community/Retail Pharmacy
  • Moscow, ID
National Provider Identifier
1699763029
Registry record updated Aug 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
1022CP Issued in ID
Legal business name
ROSAUERS SUPERMARKETS INC
Doing business as
Rosauers Pharmacy
Practice address
411 N Main St
Moscow, ID 83843-2630
Phone
(208) 882-0900
Fax
(208) 883-1407
NPI assigned
Oct 10, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2007

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

Authorized official

Name
Jeffry Philipps, RPH
Title
Prees
Phone
(509) 326-8900

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 1022CP ID Primary

Addresses

Primary practice location

411 N Main St
Moscow, ID 83843-2630

Mailing address

PO Box 9000
Spokane, WA 99209-9000

Other identifiers 1

IdentifierTypeStateIssuer
1305665OtherOTHER ID NUMBER

Other names 1

  • ROSAUERS PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930002215 ID DME Supplier - PharmacyDME Supplier - Grocery Store 9830265131 Practice locations: Moscow, ID
O20111221000241 ID Part B Supplier - Mass Immunization (Roster Biller Only) 9830265131 2 other NPIs on this enrollment
Practice locations: Lewiston, ID; Meridian, ID; Moscow, ID

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 2

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

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
Rosauers Pharmacy 9411 N Main St, Moscow, ID 83843-2630(208) 882-0900 Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) Accepts assignmentParticipating since Oct 25, 2011

National Provider Directory

National Provider Directory
Tax ID family
Rosauers Pharmacy 2920 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

Practitioners & affiliated clinicians

Practitioners 4

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": "1128902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188518400000",
    "number": "1699763029",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 N MAIN ST",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838432630",
            "telephone_number": "208-882-0900",
            "fax_number": "208-883-1407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSAUERS SUPERMARKETS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-10",
        "last_updated": "2007-08-31",
        "status": "A",
        "authorized_official_last_name": "PHILIPPS",
        "authorized_official_first_name": "JEFFRY",
        "authorized_official_title_or_position": "PREES",
        "authorized_official_telephone_number": "509-326-8900",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "ID",
            "license": "1022CP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "1305665",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ROSAUERS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Moscow, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2007; 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.