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General NPI Number Information
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NPI Number | 1356427819
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Entity Type | Organization
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Legal Business Name | RLS SUPERMARKETS LLC
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 11/25/2014
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Provider Practice Location Address
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Address Line | 4414 GUS THOMASSON RD
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City | MESQUITE
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State | TX
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Zip | 75150-2232
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Country | US
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Telephone | 972-613-5787
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Fax | 972-686-9219
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Provider Business Mailing Address
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Address Line | DEPT. D8020 PO BOX 650002
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City | DALLAS
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State | TX
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Zip | 75265
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Country | US
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Telephone | 325-277-3524
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Fax |
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Authorized Official
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Title or Position | MANAGING OFFICER
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Name | RAY SCHALEK
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Credential |
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Telephone | 325-277-3524
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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 | 27549
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License Number State | TX
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