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Provider Information for 1871603662


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THRIFTY PAYLESS INC

Other Names:  
Doing Business As: 
RITE AID PHARMACY 05732

Organization Subpart: NO

NPI: 1871603662
Last Updated: 2011-10-28
Certification Date:

Details

NameValue
NPI1871603662
Enumeration Date2006-08-30
NPI TypeNPI-2 Organization
StatusActive
Authorized Official Information Name: JENNIFER ZOREK
Title: MANAGER ONLINE ADJUDICATION
Phone: 7179755937
Mailing Address 200 NEWBERRY COMMONS
ETTERS, PA 17319-9363
United States

Phone: 717-761-2633 | Fax:717-975-8659
 
Primary Practice Address 405 WEST IMPERIAL HIGHWAY
BREA, CA 92821-4818
United States

Phone: 714-529-2176 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)0508119Other ID Number
MEDICAIDCAPHA428450
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 332B00000X - Durable Medical Equipment & Medical Supplies
Yes 3336C0003X - Pharmacy - Community/Retail PharmacyCAPHY42845