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Organization
LANE DRUG CO
Active
Organization
LANE DRUG CO
Active
Other names
Rite Aid Pharmacy 02409
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (SR MANAGER PROVIDER ENROLLMENT)
(717) 975-5937
Entity
Organization
Contact information
Practice address
4042 CLEVELAND AVENUE, CANTON, OH 44707-3624
(330) 484-3947
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
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0732925
—
OH
01
—
3652054
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/31/2006
Last updated
03/31/2016
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