Organization
RITE AID OF PENNSYLVANIA LLC
Active
Other names
RITE AID PHARMACY 00926
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (SR MANAGER PROVIDER ENROLLMENT)
(717) 975-5937
Entity
Organization
Contact information
Practice address
1440 EAST HIGH STREET, WAYNESBURG, PA 15370-9558
(724) 627-9849
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
PP410689L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0013175032
—
WV
01
—
1007292980759
MEDICAID DME
PA
05
—
1007292980759
—
PA
01
—
3914187
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
10/12/2006
Last updated
08/07/2020
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