Organization
RITE AID SPECIALTY PHARMACY LLC
Active
Other names
RITE AID PHARMACY 06800
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER M ZOREK (SR MANAGER PROVIDER ENROLLMENT)
(717) 975-5937
Entity
Organization
Contact information
Practice address
704 QUINCE ORCHARD ROAD, SUITE 150, GAITHERSBURG, MD 20878-1787
(301) 208-8958
Mailing address
200 NEWBERRY COMMONS, ETTERS, PA 17319-9363
(717) 975-5937
(717) 975-8659
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0079170
—
OH
05
—
1021545
—
VT
05
—
1028009640001
—
PA
05
—
1245537430
—
DE
05
—
1245537430
—
ID
05
—
1245537430
—
ME
05
—
1245537430
—
TN
05
—
1245537430
—
UT
05
—
1245537430
—
VA
05
—
201150910A
—
IN
01
—
2135689
NABP
—
05
—
448720600
—
MD
05
—
500655662
—
OR
05
—
7100236380
—
KY
Enumeration date
02/24/2011
Last updated
07/09/2013
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