NPIMap

Organization Active NPI

Ralphs Grocery Company

  • Community/Retail Pharmacy
  • La Quinta, CA
National Provider Identifier
1750306353
Registry record updated Oct 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY44515 Issued in CA
Legal business name
RALPHS GROCERY COMPANY
Practice address
50 929 Washington St
La Quinta, CA 92253
Phone
(760) 771-1358
Fax
(760) 564-8395
NPI assigned
Jul 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2014

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

Authorized official

Name
Karla Langworthy
Title
Manager of Pharmacy Credentialing
Phone
(513) 698-1878

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHY44515 CA Primary

Addresses

Primary practice location

50 929 Washington St
La Quinta, CA 92253

Mailing address

1100 W Artesia Blvd
Compton, CA 90220-5108

Other identifiers 2

IdentifierTypeStateIssuer
2006981OtherPK
PHA445150MedicaidCA

Other names 1

  • RALPHS PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060502000778 CA Part B Supplier - Mass Immunization (Roster Biller Only) 9133021314 16 other NPIs on this enrollment
Practice locations: Palm Springs, CA; Temecula, CA; Riverside, CA; Rancho Cucamonga, CA; Murrieta, CA; La Quinta, CA; Indio, CA; Fontana, CA…
O20090408000203 CA Part B Supplier - Mass Immunization (Roster Biller Only) 9133021314 This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 16

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

View all 16

National Provider Directory

National Provider Directory

Member of 1

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414108800000",
    "number": "1750306353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 W ARTESIA BLVD",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "902205108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 929 WASHINGTON ST",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "92253",
            "telephone_number": "760-771-1358",
            "fax_number": "760-564-8395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALPHS GROCERY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2014-10-24",
        "status": "A",
        "authorized_official_last_name": "LANGWORTHY",
        "authorized_official_first_name": "KARLA",
        "authorized_official_title_or_position": "MANAGER OF PHARMACY CREDENTIALING",
        "authorized_official_telephone_number": "513-698-1878"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY44515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2006981",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA445150",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RALPHS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Quinta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.

Verify at the official NPI Registry.