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Organization
RITE AID
Active
Organization
RITE AID
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT GERALD POLIVKA (PHARMACIST)
(330) 241-8524
Entity
Organization
Contact information
Practice address
110 S BRADLEY HWY, ROGERS CITY, MI 49779-2123
(989) 734-7392
Mailing address
110 S BRADLEY HWY, ROGERS CITY, MI 49779-2123
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302036186
MI
Other
Enumeration date
12/08/2015
Last updated
12/08/2015
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