NPIMap

Organization Active NPI

Rosauers Supermarkets Inc

  • Community/Retail Pharmacy
  • Spokane, WA
National Provider Identifier
1740278175
Registry record updated Mar 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
262010403842 Issued in WA
Legal business name
ROSAUERS SUPERMARKETS INC
Practice address
1808 W 3Rd Ave
Spokane, WA 99204-0710
Phone
(509) 838-3618
Fax
(509) 456-2358
NPI assigned
Oct 10, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2008

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 262010403842 WA Primary

Addresses

Primary practice location

1808 W 3Rd Ave
Spokane, WA 99204-0710

Mailing address

W 1808 Third Ave
Spokane, WA 99204-0710
Phone (509) 624-0126

Other identifiers 2

IdentifierTypeStateIssuer
6181507MedicaidWA
4910685OtherOTHER ID NUMBER

Other names 1

  • ROSAUERS PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080911000092 WA Part B Supplier - Mass Immunization (Roster Biller Only) 9830265131 9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Spokane, WA; Yakima, WA; Spokane Valley, WA; Ridgefield, WA; Ellensburg, WA; Colville, WA
O20100930070931 WA DME Supplier - PharmacyDME Supplier - Grocery Store 9830265131 Practice locations: Spokane, WA

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 9

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

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

Locations

1808 W 3rd Ave
Spokane, WA 99201
Phone (509) 624-0126

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": "1204675200000",
    "number": "1740278175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W 1808 THIRD AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992040710",
            "telephone_number": "509-624-0126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1808 W 3RD AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992040710",
            "telephone_number": "509-838-3618",
            "fax_number": "509-456-2358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSAUERS SUPERMARKETS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-10",
        "last_updated": "2008-03-05",
        "status": "A",
        "authorized_official_last_name": "PHILIPPS",
        "authorized_official_first_name": "JEFFRY",
        "authorized_official_title_or_position": "PRES",
        "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": "WA",
            "license": "262010403842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6181507",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "4910685",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ROSAUERS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; 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.