Healthcare Provider Details

I. General information

NPI: 1063437663
Provider Name (Legal Business Name): RALPHS GROCERY COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40355 WINCHESTER RD
TEMECULA CA
92591-5520
US

IV. Provider business mailing address

40355 WINCHESTER RD
TEMECULA CA
92591-5520
US

V. Phone/Fax

Practice location:
  • Phone: 951-296-5248
  • Fax: 951-296-5243
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPHY44076
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: REBECCA CUPP
Title or Position: PHARMACY MERCHANDISER
Credential:
Phone: 310-884-4722