Organization
THRIFTY PAYLESS INC
Active
Other names
Rite Aid Pharmacy 05592
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
2060 SOUTH HACIENDA BOULEVARD, HACIENDA HEIGHTS, CA 91745-4240
(626) 333-5642
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
PHY42388
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0517322
OTHER ID NUMBER
—
05
—
BBBPHA423880
—
CA
01
—
PHA423880
MEDICAID DME
CA
Enumeration date
08/10/2006
Last updated
10/27/2011
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