Organization
PERRY DRUG STORES INC AND SUBSIDIARIES
Active
Other names
RITE AID PHARMACY 04330
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
557 NORTH CEDAR STREET, IMLAY CITY, MI 48444-1165
(810) 724-0576
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
3022
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2306151
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
2306151
—
MI
Enumeration date
08/30/2006
Last updated
03/16/2009
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