Organization
RITE AID OF NEW JERSEY INC
Active
Other names
RITE AID PHARMACY 04094
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER M JOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
1000 KINGS HIGHWAY, WEST DEPTFORD, NJ 08086
(717) 731-2633
Mailing address
200 NEWBERRY COMMONS, ETTERS, PA 17319
(717) 761-2366
(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
05
—
0238252
—
NJ
01
—
0239721
MEDICAID DME
NJ
01
—
3196638
NCPDP
NJ
Enumeration date
11/13/2009
Last updated
08/17/2011
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