# RITE AID PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104370899
- **Authorized official:** DIANE KURISCAK PHARMD (PHARMACY DISTRICT MANAGER)
- **Authorized official phone:** (774) 218-5495

## Contact information

- **Practice address:** 1665 MINERAL SPRING AVE, NORTH PROVIDENCE, RI 02904-4003
- **Practice address phone:** (401) 353-3113
- **Mailing address:** 96 GANO ST, APT \#4, PROVIDENCE, RI 02906-3848
- **Mailing address phone:** (401) 218-5356

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | RPH05626 | RI | Yes |

## Other

- **Enumeration date:** 08/10/2016
- **Last updated:** 08/10/2016