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Organization

GENOVESE DRUG STORES INC

Active
Other names
RITE AID PHARMACY 10612
Organization subpart
No

Provider details

NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization

Contact information

Practice address
225 FOREST AVENUE, GLEN COVE, NY 11542-2028
(516) 759-1201
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
3336C0003X
Community/Retail Pharmacy
Primary
021780
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01441092
NY
01
3333565
OTHER ID NUMBER
Enumeration date
09/22/2006
Last updated
10/04/2011
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