Organization
PERRY DRUG STORES INC AND SUBSIDIARIES
Active
Other names
Rite Aid Pharmacy 04303
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
597 SOUTH ADAMS ROAD, ADAMS SQUARE, BIRMINGHAM, MI 48009-6756
(248) 647-4470
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
1936
MI
3336C0003X
Community/Retail Pharmacy
Primary
1936
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2303939
NCPDP
MI
05
—
2303939
—
MI
Enumeration date
07/25/2006
Last updated
08/08/2008
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