NPIMap

Organization Active NPI

Randalls Food & Drugs LP

Doing business as Randalls Pharmacy #3145

  • Community/Retail Pharmacy
  • Leander, TX
National Provider Identifier
1750830550
Registry record updated Oct 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
31059 Issued in TX
Legal business name
RANDALLS FOOD & DRUGS LP
Doing business as
Randalls Pharmacy #3145
Practice address
3441 Lakeline Blvd
Leander, TX 78641-5007
Phone
(713) 268-3861
NPI assigned
Sep 22, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2018

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

Authorized official

Name
Tiffany Eliopulos
Title
Assistant Manager, Enrollments
Phone
(208) 395-3906

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X 31059 TX Primary

Addresses

Primary practice location

3441 Lakeline Blvd
Leander, TX 78641-5007

Mailing address

250 E Parkcenter Blvd
Boise, ID 83706-3940

Other identifiers 1

IdentifierTypeStateIssuer
2164297OtherPK

Other names 1

  • RANDALLS PHARMACY #3145 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170106000317 TX DME Supplier - PharmacyDME Supplier - Grocery Store 6901703974 Practice locations: Leander, TX

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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2247520Randalls Pharmacy #31453441 N Lakeline Blvd, Leander, TX 78641Certificate of waiverJan 5, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Randalls Pharmacy #31453441 N Lakeline Blvd, Leander, TX 78641-5007(737) 843-3080 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Orthoses: Off-The-Shelf|Ostomy Supplies|Urological Supplies|Surgical Dressings Does not accept assignmentParticipating since Jan 1, 2017

National Provider Directory

National Provider Directory
Tax ID family
Randalls Food Drugs LP16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Member of 1

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

  • Safeway Inc

    dba Safeway Pharmacy #0563

    • Community/Retail Pharmacy
    • Sunnyside, WA
    • NPI 1861421885

    Member Of

    NPD member

NPI Registry JSON

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

{
    "created_epoch": "1474502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538956800000",
    "number": "1750830550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 E PARKCENTER BLVD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837063940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3441 LAKELINE BLVD",
            "city": "LEANDER",
            "state": "TX",
            "postal_code": "786415007",
            "telephone_number": "713-268-3861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDALLS FOOD & DRUGS LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-22",
        "last_updated": "2018-10-08",
        "status": "A",
        "authorized_official_last_name": "ELIOPULOS",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "ASSISTANT MANAGER, ENROLLMENTS",
        "authorized_official_telephone_number": "208-395-3906"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "31059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2164297",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RANDALLS PHARMACY #3145",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "RANDALLS PHARMACY #3145",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Leander, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2018; 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.