Organization
RALPHS GROCERY COMPANY
Active
Other names
FOOD4LESS
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA CUPP (PHARMACY MERCHANDISER)
(310) 884-4722
Entity
Organization
Contact information
Practice address
500 HACIENDA DR, VISTA, CA 92081-6604
(760) 630-5121
(760) 630-5186
Mailing address
1100 W ARTESIA BLVD, COMPTON, CA 90220-5108
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
PHY46704
CA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5613232
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
PHA467040
—
CA
01
—
PHY46704
MEDICARE MASS IMMUNIZER
—
Enumeration date
12/01/2006
Last updated
09/20/2007
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