Provider Demographics
NPI:1467509950
Name:RISER FOODS COMPANY
Entity Type:Organization
Organization Name:RISER FOODS COMPANY
Other - Org Name:GIANT EAGLE PHARMACY #4876
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF MANAGED CARE
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:B
Authorized Official - Last Name:KRASNOW
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:412-968-1550
Mailing Address - Street 1:101 KAPPA DRIVE
Mailing Address - Street 2:ATTN DIRECTOR OF MANAGED CARE
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238
Mailing Address - Country:US
Mailing Address - Phone:412-968-1550
Mailing Address - Fax:412-968-1727
Practice Address - Street 1:3628 MAYFIELD RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-1403
Practice Address - Country:US
Practice Address - Phone:216-291-8881
Practice Address - Fax:216-291-6104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2020-08-22
Deactivation Date:2007-07-11
Deactivation Code:
Reactivation Date:2008-02-22
Provider Licenses
StateLicense IDTaxonomies
OH3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy