NPIMap

Organization Active NPI

Ralphs Grocery Company

  • Community/Retail Pharmacy
  • Fontana, CA
National Provider Identifier
1871650127
Registry record updated May 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY48297 Issued in CA
Legal business name
RALPHS GROCERY COMPANY
Practice address
16225 Sierra Lakes Pkwy
Fontana, CA 92336-1245
Phone
(909) 357-2525
Fax
(909) 357-3047
NPI assigned
Jan 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2016

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

Authorized official

Name
Allison Muennich
Title
Manager of Pharmacy Licensing
Phone
(513) 762-1019

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X PHY48297 CA Primary

Addresses

Primary practice location

16225 Sierra Lakes Pkwy
Fontana, CA 92336-1245

Mailing address

PO Box 842772
Boston, MA 02284-2772
Phone (513) 762-1019

Other identifiers 1

IdentifierTypeStateIssuer
2115240OtherPK

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
This NPI is an additional NPI on the enrollment
Practice locations: Palm Springs, CA; Temecula, CA; Riverside, CA; Rancho Cucamonga, CA; Murrieta, CA; La Quinta, CA; Indio, CA; Fontana, CA…
O20100930046231 CA DME Supplier - Pharmacy 9133021314 Practice locations: Fontana, CA

Other NPIs on the same Medicare enrollment 16

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

View all 16

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
05D2003001Ralphs Pharmacy #113 Mobile Clia16225 Sierra Lakes Pkwy, Fontana, CA 92336Certificate of waiverJan 28, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Ralphs 11316225 Sierra Lakes Pkwy, Fontana, CA 92336-1245(909) 357-2525 Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Canes and/or Crutches|Walkers|Ostomy Supplies|Urological Supplies|Enteral Nutrients|Enteral Equipment and/or Supplies|Nebulizer Equipment a… Accepts assignmentParticipating since Feb 25, 2013

National Provider Directory

National Provider Directory
Tax ID family
Ralphs Grocery Company80 organizations share this tax ID, including this one

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.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463356800000",
    "number": "1871650127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 842772",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022842772",
            "telephone_number": "513-762-1019",
            "fax_number": "513-762-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16225 SIERRA LAKES PKWY",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361245",
            "telephone_number": "909-357-2525",
            "fax_number": "909-357-3047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALPHS GROCERY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2016-05-16",
        "status": "A",
        "authorized_official_last_name": "MUENNICH",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_title_or_position": "MANAGER OF PHARMACY LICENSING",
        "authorized_official_telephone_number": "513-762-1019"
    },
    "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": "CA",
            "license": "PHY48297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2115240",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RALPHS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fontana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2016; 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.