NPIMap

Organization Active NPI

Riser Foods Company

Doing business as Giant Eagle Pharmacy 1284

  • Community/Retail Pharmacy
  • Avon Lake, OH
National Provider Identifier
1871508788
Registry record updated May 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
RISER FOODS COMPANY
Doing business as
Giant Eagle Pharmacy 1284
Practice address
31990 Walker Rd
Avon Lake, OH 44012-2045
Phone
(440) 933-9598
Fax
(440) 933-7571
NPI assigned
Jul 29, 2006
Last updated
May 19, 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 19, 2009

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

Authorized official

Name
Debra Krasnow, PHARMDNPI 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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 021087350 OH
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

31990 Walker Rd
Avon Lake, OH 44012-2045

Mailing address

101 Kappa Dr
Pittsburgh, PA 15238-2809

Other identifiers 3

IdentifierTypeStateIssuer
P00419119OtherOHRRB
3665657OtherOTHER ID NUMBER-COMMERCIAL NUMBER
2078577MedicaidOH

Other names 1

  • GIANT EAGLE PHARMACY 1284 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…
O20100930053698 OH DME Supplier - Pharmacy 5193700292 Practice locations: Avon Lake, 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
Giant Eagle Pharmacy #128431990 Walker Rd, Avon Lake, OH 44012-2181(440) 933-9598 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 19

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

View all 19

Member of 1

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

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": "1242691200000",
    "number": "1871508788",
    "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": "31990 WALKER RD",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "440122045",
            "telephone_number": "440-933-9598",
            "fax_number": "440-933-7571"
        }
    ],
    "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": "2009-05-19",
        "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",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "OH",
            "license": "021087350",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRB",
            "identifier": "P00419119",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3665657",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2078577",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GIANT EAGLE PHARMACY 1284",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Avon Lake, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.