Organization
MAXI DRUG INC
Active
Other names
RITE AID PHARMACY 10074
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
107 MAIN STREET, GREENFIELD, MA 01301-3209
(413) 774-3976
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
2895
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0447692
—
MA
05
—
1020082
—
VT
01
—
2235504
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/22/2006
Last updated
02/08/2012
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