Provider Information for 1952490617
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RITE AID OF PENNSYLVANIA LLC
Other Names:Doing Business As:RITE AID PHARMACY 04419Organization Subpart: NO
NPI: 1952490617
Last Updated: 2020-08-17
Certification Date: 2020-08-17
Certification Date: 2020-08-17
Details
Name | Value | ||||||||||||||||
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NPI | 1952490617 | ||||||||||||||||
Enumeration Date | 2006-10-12 | ||||||||||||||||
NPI Type | NPI-2 Organization | ||||||||||||||||
Status | Active | ||||||||||||||||
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 | 1529 FREEPORT ROAD NATRONA HEIGHTS, PA 15065-1314 United States Phone: 724-226-4725 | Fax: | ||||||||||||||||
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