Organization
PERRY DRUG STORES INC AND SUBSIDIARIES
Active
Other names
RITE AID PHARMACY 04305
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER OL ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
2971 WEST MAPLE ROAD, TROY, MI 48084-7032
(248) 288-4385
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
5301000229
MI
3336C0003X
Community/Retail Pharmacy
Primary
5301000229
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2303953
NCPDP
MI
05
—
2303953
—
MI
Enumeration date
08/08/2006
Last updated
03/11/2009
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