Organization Active NPI

RLS Supermarkets LLC

  • Community/Retail Pharmacy
  • Dallas, TX
National Provider Identifier
1700824166
Registry record updated Jul 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
29871 Issued in TX
Legal business name
RLS SUPERMARKETS LLC
Practice address
10203 E Northwest Hwy
Dallas, TX 75238-4407
Phone
(214) 221-5007
Fax
(214) 221-5082
NPI assigned
Jun 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2016

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

Authorized official

Name
John Piper
Title
Director of Pharmacy
Phone
(972) 754-4436

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 29871 TX Primary

Addresses

Primary practice location

10203 E Northwest Hwy
Dallas, TX 75238-4407

Mailing address

10203 E Northwest Hwy
Dallas, TX 75238-4407
Phone (214) 221-5007

Other identifiers 2

IdentifierTypeStateIssuer
2150201OtherPK
470478MedicaidTX

Other names 1

  • MINYARD PHARMACY #97 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041014000405 TX Part B Supplier - Centralized Flu Biller 8729983515 This NPI is an additional NPI on the enrollment
Practice locations: Boise, ID

National Provider Directory

National Provider Directory

Member of 3

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

Locations

250 E Parkcenter Blvd
#2D
Boise, ID 83706
Phone (208) 395-3954

6464 E Mockingbird Ln
Dallas, TX 75214
Phone (214) 827-4230

3524 McKinney Ave
Dallas, TX 75204
Phone (214) 528-0516

4000 William D Tate Ave
Grapevine, TX 76051
Phone (817) 684-9211

2200 W Shady Grove Rd
#31
Irving, TX 75060
Phone (972) 790-3753

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": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468886400000",
    "number": "1700824166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10203 E NORTHWEST HWY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752384407",
            "telephone_number": "214-221-5007",
            "fax_number": "214-221-5082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10203 E NORTHWEST HWY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752384407",
            "telephone_number": "214-221-5007",
            "fax_number": "214-221-5082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RLS SUPERMARKETS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2016-07-19",
        "status": "A",
        "authorized_official_last_name": "PIPER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "972-754-4436"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "29871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2150201",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "470478",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MINYARD PHARMACY #97",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2016; 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.