MEDICARE: RALEYS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	PHY53523	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0578813	OTHER		NCPDP

General Provider Information

NPI Number	:	1376653030
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RALEYS

Provider Business Mailing Address
First Line	:	500 WEST CAPITOL AVE.
Second Line	:
City	:	WEST SACRAMENTO
State	:	CA
Zip	:	95605-2696
Country	:	US
Telephone Number	:	916-373-6146
Fax Number	:	916-372-6226

Provider Business Practice Location Address
First Line	:	890 SOUTHAMPTON RD
Second Line	:
City	:	BENICIA
State	:	CA
Zip	:	94510-1907
Country	:	US
Telephone Number	:	707-746-5565
Fax Number	:

Authorized Official
Title or Position	:	SECRETARY
Name	:	HELEN S SINGMASTER
Credential	:
Telephone Number	:	916-373-6394

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	06/04/2015

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Directions to “RALEYS ” Practice Location

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