Provider Demographics
NPI:1326053232
Name:RISER FOODS COMAPNY
Entity type:Organization
Organization Name:RISER FOODS COMAPNY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:TSIPAKIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-963-6200
Mailing Address - Street 1:700 CRANBERRY WOODS DR
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-5213
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15919 PEARL RD
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-6031
Practice Address - Country:US
Practice Address - Phone:440-238-4111
Practice Address - Fax:440-238-4225
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GIANT EAGLE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-29
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0223211003336C0003X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00419119OtherMEDICARE RAILROAD FLU
OH2078406Medicaid
3665253OtherOTHER ID NUMBER-COMMERCIAL NUMBER
OHRIFV93981Medicare PIN
3665253OtherOTHER ID NUMBER-COMMERCIAL NUMBER