Organization
RITE AID OF CONNECTICUT INC
Active
Other names
RITE AID PHARMACY 04092
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER M ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
645 FOXON ROAD, EAST HAVEN, CT 06513-1951
(203) 468-1039
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008002647
MEDICAID DME
CT
05
—
008002649
—
CT
01
—
0721313
NCPDP
—
Enumeration date
11/11/2008
Last updated
02/10/2012
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