Organization
PERRY DRUG STORES INC AND SUBSIDIARIES
Active
Other names
RITE AID PHARMACY 04390
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
11585 EAST TWELVE MILE ROAD, 12 HOOVER SHOPPING CENTER, WARREN, MI 48093-2645
(586) 751-0300
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
1352
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2331623
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
2331623
—
MI
Enumeration date
08/29/2006
Last updated
10/27/2008
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