Organization
GENOVESE DRUG STORES INC
Active
Other names
RITE AID PHARMACY 10387
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
525 TUNXIS CORNER, FAIRFIELD, CT 06430-0000
(203) 368-4666
Mailing address
200 NEWBERRY COMMONS, ETTERS, PA 17319-9363
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1884
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004087921
—
CT
01
—
004094463
MEDICAID DME
CT
01
—
0712996
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/22/2006
Last updated
01/30/2009
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