NPIMap

Organization Active NPI

Raley'S Arizona LLC

  • Community/Retail Pharmacy
  • Tucson, AZ
National Provider Identifier
1720190713
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
RALEY'S ARIZONA LLC
Practice address
1221 W Irvington Rd
Tucson, AZ 85714-1167
Phone
(520) 434-6921
Fax
(520) 434-6923
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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

Authorized official

Name
Mike McKinley
Title
Director of Pharmacy
Phone
(480) 895-5372

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Y003886 AZ
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

1221 W Irvington Rd
Tucson, AZ 85714-1167

Mailing address

1221 W Irvington Rd
Tucson, AZ 85714-1167
Phone (520) 434-6921

Other identifiers 2

IdentifierTypeStateIssuer
827553MedicaidAZ
0327999OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 2

  • FOOD CITY Doing business as
  • Food City United Drug 156 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230308001395 AZ Part B Supplier - Pharmacy 0840663050 37 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Queen Creek, AZ; Scottsdale, AZ; Sedona, AZ; Sierra Vista, AZ; Sun City West, AZ; Sun Lakes, AZ; Surprise, AZ; Tempe, AZ…

Other NPIs on the same Medicare enrollment 37

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

View all 37

National Provider Directory

National Provider Directory
Tax ID family
Bashas39 organizations share this tax ID, including this one

Other organizations with this tax ID 38

Organizations that report the same tax identification number in the National Provider Directory.

View all 38

Locations

4940 S Gilbert Rd
Chandler, AZ 85249
Phone (480) 883-2241

99 S Higley Rd
Gilbert, AZ 85296
Phone (480) 926-5221

1831 Kiowa Ave
Lake Havasu City, AZ 86403
Phone (928) 855-2494

2864 N Power Rd
Mesa, AZ 85215
Phone (480) 654-0200

450 N Grand Court Plz
Nogales, AZ 85621
Phone (480) 985-5372

20351 N Lake Pleasant Rd
Peoria, AZ 85382
Phone (480) 825-6115

4855 E Warner Rd
Phoenix, AZ 85044
Phone (480) 940-6396

13940 W Meeker Blvd
Sun City West, AZ 85375
Phone (623) 945-6221

3275 N Swan Rd
Tucson, AZ 85712
Phone (520) 323-5821

1221 W Irvington Rd
Tucson, AZ 85714
Phone (520) 434-6921

6900 E Sunrise Dr
Tucson, AZ 85750
Phone (520) 299-3378

Practitioners & affiliated clinicians

Practitioners 8

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": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650240000000",
    "number": "1720190713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 W IRVINGTON RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857141167",
            "telephone_number": "520-434-6921",
            "fax_number": "520-434-6923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 W IRVINGTON RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857141167",
            "telephone_number": "520-434-6921",
            "fax_number": "520-434-6923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALEY'S ARIZONA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A",
        "authorized_official_last_name": "MCKINLEY",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "480-895-5372"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AZ",
            "license": "Y003886",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "827553",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0327999",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FOOD CITY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Food City United Drug 156",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2022; 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.