Organization
THRIFTY PAYLESS INC
Active
Other names
RITE AID PHARMACY 05725
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
23975 IRONWOOD AVE, MORENO VALLEY, CA 92557-7153
(951) 242-1742
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
PHY44061
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0596443
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
PHA440610
—
CA
Enumeration date
08/30/2006
Last updated
12/18/2019
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