Organization
RITE AID OF CONNECTICUT INC
Active
Other names
RITE AID PHARMACY 03619
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
1060 EAST MAIN STREET, BRIDGEPORT, CT 06608-1915
(203) 382-0009
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
1540
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004140109
—
CT
01
—
004140141
MEDICAID DME
CT
01
—
0716362
NCPDP
—
Enumeration date
08/30/2006
Last updated
02/10/2012
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