Organization
ECKERD CORPORATION
Active
Other names
RITE AID PHARMACY 10779
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
117 ERIE BLVD WEST, ROME, NY 13440-5739
(315) 336-2310
Mailing address
200 NEWBERRY COMMONS, ETTERS, PA 17319-9363
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
024019
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00572707
—
NY
01
—
3344190
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/22/2006
Last updated
09/03/2008
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