Organization
RITE AID OF MICHIGAN INC
Active
Other names
RITE AID PHARMACY 04022
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER M ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
59010 GRATIOT AVENUE, NEW HAVEN, MI 48048-2073
(586) 749-0009
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
—
1184875825
MEDICAID DME
MI
05
—
2371742
—
MI
Enumeration date
09/30/2008
Last updated
08/05/2009
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