NPIMap

Organization Active NPI

Riser Foods Company

Doing business as Giant Eagle Pharmacy 6377

  • Community/Retail Pharmacy
  • Painesville, OH
National Provider Identifier
1770598690
Registry record updated May 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
021214750 Issued in OH
Legal business name
RISER FOODS COMPANY
Doing business as
Giant Eagle Pharmacy 6377
Practice address
1201 Mentor Ave
Painesville, OH 44077-1833
Phone
(440) 358-7769
Fax
(440) 358-7772
NPI assigned
Jul 29, 2006
Last updated
May 20, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
GIANT EAGLE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 20, 2009

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

Authorized official

Name
Debra KrasnowNPI 1821286717
Title
Director Managed Care
Phone
(412) 968-1550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 021214750 OH Primary

Addresses

Primary practice location

1201 Mentor Ave
Painesville, OH 44077-1833

Mailing address

101 Kappa Dr
Pittsburgh, PA 15238-2809

Other identifiers 3

IdentifierTypeStateIssuer
3668312OtherOTHER ID NUMBER-COMMERCIAL NUMBER
P00419119OtherOHRRB
2181151MedicaidOH

Other names 1

  • GIANT EAGLE PHARMACY 6377 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040622001601 OH Part B Supplier - Mass Immunization (Roster Biller Only) 5193700292 This NPI is an additional NPI on the enrollment
Practice locations: Medina, OH; Mentor, OH; Mentor on the Lake, OH; Middlburg, OH; Middlefield, OH; North Olmsted, OH; North Ridgeville, OH; North Royalton, OH…
O20100930040993 OH DME Supplier - PharmacyDME Supplier - Grocery Store 5193700292 Practice locations: Painesville, OH

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Riser Foods Company1201 Mentor Ave, Painesville, OH 44077-1833(440) 358-7769 Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Canes and/or Crutches|Ostomy Supplies|Nebulizer Equipment and/or Supplies|Surgical Dressings Does not accept assignmentParticipating since Jan 1, 2016

National Provider Directory

National Provider Directory
Tax ID family
Giant Eagle Pharmacy 408651 organizations share this tax ID, including this one
Part of
Giant Eagle Pharm 4

Organizations with this tax ID in the same state 23

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 23

Member of 1

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

Locations

1201 Mentor Ave
Painesville, OH 44077
Phone (440) 358-7769

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242777600000",
    "number": "1770598690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 KAPPA DR",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152382809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 MENTOR AVE",
            "city": "PAINESVILLE",
            "state": "OH",
            "postal_code": "440771833",
            "telephone_number": "440-358-7769",
            "fax_number": "440-358-7772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RISER FOODS COMPANY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GIANT EAGLE INC",
        "enumeration_date": "2006-07-29",
        "last_updated": "2009-05-20",
        "status": "A",
        "authorized_official_last_name": "KRASNOW",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "DIRECTOR MANAGED CARE",
        "authorized_official_telephone_number": "412-968-1550"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "021214750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3668312",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRB",
            "identifier": "P00419119",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2181151",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GIANT EAGLE PHARMACY 6377",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Painesville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2009; 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.