Organization
RITE AID DRUG PALACE INC
Active
Other names
RITE AIDPHARMACY 01711
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER OL ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
408 GRAND STREET, NEW YORK, NY 10002-4702
(212) 529-7115
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
—
01004984
MEDICAID DME
NY
05
—
01004984
—
NY
01
—
3388990
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/30/2006
Last updated
08/27/2020
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