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General NPI Number Information
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NPI Number | 1396752317
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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 | 08/02/2006
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Last Update Date | 05/06/2009
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Provider Practice Location Address
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Address Line | 6079 ANDREWS RD
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City | MENTOR ON THE LAKE
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State | OH
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Zip | 44060-2821
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Country | US
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Telephone | 440-306-0011
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Fax | 440-306-0022
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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 |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR MANAGED CARE
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Name | DEBRA 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 | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 021374850
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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