Organization
GENOVESE DRUG STORES INC
Active
Other names
Rie Aid Pharmacy 10616
Organization subpart
No
Provider details
NPI number
Authorized official
JENNI ZOREK (MNGR OL ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
400 SUNRISE HIGHWAY, LYNBROOK, NY 11563-3023
(516) 593-4180
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
22717
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001589019
MEDICAID DME
NY
05
—
001589019
—
NY
01
—
3309716
NABP
—
Enumeration date
07/04/2006
Last updated
10/04/2011
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