MEDICARE: RIESBECK FOOD MARKETS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3671307	OTHER		NCPDP
2	021350650	OTHER	OH	STATE PHARMACY LICENSE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225037617
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIESBECK FOOD MARKETS, INC.

Provider Business Mailing Address
First Line	:	48661 NATIONAL RD W
Second Line	:
City	:	SAINT CLAIRSVILLE
State	:	OH
Zip	:	43950-9701
Country	:	US
Telephone Number	:	740-695-7050
Fax Number	:	740-695-7555

Provider Business Practice Location Address
First Line	:	2200 JUNE PKWY
Second Line	:
City	:	SOUTH ZANESVILLE
State	:	OH
Zip	:	43701-6377
Country	:	US
Telephone Number	:	740-450-7859
Fax Number	:	740-450-7943

Authorized Official
Title or Position	:	PRESIDENT AND CHIEF EXECUTIVE OFFIC
Name	:	MR. RICHARD L. RIESBECK
Credential	:
Telephone Number	:	740-695-7050

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	03/07/2023

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Directions to “RIESBECK FOOD MARKETS, INC. ” Practice Location

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