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Organization
LANE DRUG CO
Active
Organization
LANE DRUG CO
Active
Other names
Rite Aid Pharmacy 02403
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
875 LEXINGTON AVENUE, MANSFIELD, OH 44907-1945
(419) 756-8329
Mailing address
200 NEWBERRY COMMONS, ETTERS, PA 17319-9363
(717) 761-2633
(717) 975-8659
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
OH
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0732256
—
OH
01
—
3651999
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/31/2006
Last updated
07/12/2011
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