Provider Demographics
NPI:1588663074
Name:RIESBECK FOOD MARKETS, INC.
Entity Type:Organization
Organization Name:RIESBECK FOOD MARKETS, INC.
Other - Org Name:RIESBECK'S #6 PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES. & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:RIESBECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-695-7050
Mailing Address - Street 1:48661 NATIONAL RD W
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-9701
Mailing Address - Country:US
Mailing Address - Phone:740-695-7050
Mailing Address - Fax:740-695-7555
Practice Address - Street 1:55 S 23RD ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725-2180
Practice Address - Country:US
Practice Address - Phone:740-432-3810
Practice Address - Fax:740-432-6803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH020601600OtherSTATE PHARMACY BOARD
OH0756614Medicaid
3652941OtherNCPDP
3652941OtherNCPDP