Organization
RITE AID OF NEW YORK INC
Active
Other names
Rite Aid Pharmacy 01674
Organization subpart
No
Provider details
NPI number
Authorized official
JENNI ZOREK (MANAGER OL ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
3950 UNION ROAD, CHEEKTOWAGA, NY 14225-4252
(716) 634-3603
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
—
00921462
MEDICAID DME
NY
05
—
00921462
—
NY
Enumeration date
08/31/2006
Last updated
12/29/2011
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