Organization
PERRY DRUG STORES INC AND SUBSIDIARIES
Active
Other names
RITE AID PHARMACY 04485
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
3456 EAST JEFFERSON AVENUE, DETROIT, MI 48207-4200
(313) 259-6520
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
4652
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2342397
OTHER ID NUMBER
—
05
—
2342397
—
MI
Enumeration date
07/25/2006
Last updated
12/12/2017
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