RALEY'S
NPI 1225667181
Pharmacy - Community/Retail Pharmacy in Sacramento, CA

Q: What is Raley's's NPI number?

The NPI number for Raley's is 1225667181. It was assigned to this organization in the NPPES registry on April 3, 2020. The provider is doing business as Raley's Pharmacy #415.

Q: What is Raley's's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Q: When was this NPI record last updated?

The NPPES record for Raley's was last updated on April 3, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 03, 2020

4690 FREEPORT BLVD, SACRAMENTO, CA 95822(916) 452-3811 Get Directions Write a Review

NPPES record last updated: April 3, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Raley's NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RALEY'S (NPI 1225667181), doing business as Raley's Pharmacy #415, is a healthcare organization registered as a community/retail pharmacy in Sacramento, California and active in the NPI registry since April 2020. The organization lists Alisha Reynoso, Pharmacy Operations Analyst, as its authorized official.

NPPES Registry Identity

NPI1225667181

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameRALEY'S

Location Address4690 FREEPORT BLVDSacramento, CA 95822

Mailing Address4690 Freeport BlvdSacramento, CA 95822 · (916) 452-3811

Phone(916) 452-3811

Organization SubpartNo

Authorized OfficialAlisha ReynosoPharmacy Operations Analyst · (916) 376-6687

Enumeration DateApril 3, 2020

NPPES CertifiedApril 3, 2020

✔ NPI 1225667181 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers

Taxonomy Code3336C0003X

Definition

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.

4690 FREEPORT BLVD, Sacramento, CA 95822

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Other Names 1

Doing Business AsRaley's Pharmacy #415

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arkansas Health & Wellness and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Raley's is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by November 30, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date

StateCaliforniaEnrollment IDO20040831000246Non-DME Part B · Mass Immunization (Roster Biller Only)Due dateNovember 30, 2026

Source: CMS Revalidation Due Date List, October 2026 release.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

USMAN SALEEM

Pharmacist

4690 FREEPORT BLVD
SACRAMENTO, CA 95822

Sacramento County (916) 451-0142

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Raley's's NPI number?

The NPI number for Raley's is 1225667181. It was assigned to this organization in the NPPES registry on April 3, 2020. The provider is doing business as Raley's Pharmacy #415.

Where is Raley's located?

Raley's is located at 4690 Freeport Blvd, Sacramento, CA 95822. The listed phone number is (916) 452-3811.

What is Raley's's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Is Raley's enrolled in Medicare?

Yes. Raley's is registered in the Medicare PECOS enrollment system.

When is Raley's's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (California, Mass Immunization (Roster Biller Only)) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

What insurance does Raley's accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arkansas Health & Wellness and 47 other insurers list Raley's as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Raley's was last updated on April 3, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.