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General NPI Number Information
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NPI Number | 1245371186
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Entity Type | Organization
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Legal Business Name | RISER FOODS COMPANY
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 04/16/2009
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Provider Practice Location Address
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Address Line | 6259 MAYFIELD RD
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City | MAYFIELD HEIGHTS
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State | OH
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Zip | 44124-3217
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Country | US
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Telephone | 440-449-3940
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Fax | 440-449-9388
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Provider Business Mailing Address
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Address Line | 101 KAPPA DR
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City | PITTSBURGH
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State | PA
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Zip | 15238-2809
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Country | US
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Telephone | 412-968-1550
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Fax | 412-968-1561
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Authorized Official
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Title or Position | DIRECTOR OF MANAGED CARE
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Name | MS. DEBRA B. KRASNOW
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Credential | PHARMD
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Telephone | 412-968-1550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 02-1643550
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License Number State | OH
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