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Deactivated NPI 1689784357 Deactivated / Inactive NPI

Raleys

Pharmacy - Community/Retail Pharmacy • Fallon, NV

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Raleys has officially deactivated this NPI record and ceased active healthcare operations.

Registration / Start Date August 30, 2006

NPI Deactivation Date December 06, 2019

Total Practice Duration ~13 Years of Practice (2006 – 2019)

About Raleys NPI 1689784357 Summary

Raleys was a registered healthcare organization specializing in Pharmacy - Community/Retail Pharmacy located in Fallon, NV. Operating from its primary practice location at 2105 W WILLIAMS AVE, the facility provided medical services under NPI record 1689784357 prior to official deactivation on December 06, 2019.

Administrative records indicate Flint Pendergraft as the registered authorized official.

Facility Location & Contact Primary Location

Facility Address

2105 W Williams Ave

Fallon, NV 894062612

Telephone 7754237111

Authorized Official Information

Authorized Contact Name

Flint Pendergraft

Official Telephone

9163736146

Facility Classifications & Specialties

Pharmacy - Community/Retail Pharmacy Primary Taxonomy

NUCC Taxonomy Code: 3336C0003X

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

Facility & Registry History Timeline

Chronological log of verified NPI organization updates, branch relocations, and registry updates

7 Historical Events

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NPI Profile Deactivated December 06, 2019

Record deactivated on December 06, 2019

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NPI Profile Active March 03, 2011

NPI status registered as active in NPPES database

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Updated Practice Location March 03, 2011

Registered at 2105 W WILLIAMS AVE, FALLON, NV 894062612 (Tel: 7754237111)

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Updated Business Mailing Address March 03, 2011

Registered at 500 WEST CAPITOL AVE., WEST SACRAMENTO, CA 956052696 (Tel: 9163736146)

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Organization / Clinic Name Updated March 03, 2011

Operating as RALEYS

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Medical Taxonomy / Specialty Registered (Primary Specialty) March 03, 2011

Pharmacy (License #PH00469 in NV)

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Initial NPI Registration & Enumeration August 30, 2006

First registered as active Healthcare Organization in NPPES Database.

Patient & Community Reviews

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NPI Organization Metadata

NPI Number: 1689784357

Entity Type:

Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)

Enumeration Date: August 30, 2006

Last Update: March 03, 2011

Deactivation Date: December 06, 2019

Update or Correct Listing

Mailing Address

500 West Capitol Ave.

West Sacramento, CA 956052696

Phone: 9163736146

Public Domain Record This organization profile is sourced from public domain datasets published by CMS and NPPES under FOIA.

⚠️ Medical Disclaimer

Facility details are provided for public information only. In case of a medical emergency, call 911 immediately.