Organization
PERRY DRUG STORES INC AND SUBSIDIARIES
Active
Other names
RITE AID PHARMACY 04334
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (SR MANAGER PROVIDER ENROLLMENT AND)
(717) 975-5937
Entity
Organization
Contact information
Practice address
19016 FORT ST, RIVERVIEW COMMONS, RIVERVIEW, MI 48193-6701
(734) 479-2010
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
3067
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2308511
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
2308511
—
MI
Enumeration date
08/29/2006
Last updated
01/13/2015
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