Healthcare Provider Details

I. General information

NPI: 1598764086
Provider Name (Legal Business Name): RIESBECK FOOD MARKETS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 03/07/2023
Certification Date: 12/30/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 PLAZA DR
ST. CLAIRSVILLE OH
43950
US

IV. Provider business mailing address

48661 NATIONAL ROAD
ST. CLAIRSVILLE OH
43950
US

V. Phone/Fax

Practice location:
  • Phone: 740-695-0274
  • Fax: 740-695-2412
Mailing address:
  • Phone: 740-695-7050
  • Fax: 740-695-7555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. RICHARD L. RIESBECK
Title or Position: PRESIDENT & CHIEF EXECUTIVE OFFICER
Credential:
Phone: 740-695-7050