Organization
RITE AID PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIMON IGHO IDIARE (STAFF PHARMACIST)
(615) 852-6133
Entity
Organization
Contact information
Practice address
116 S MAIN ST, GOODLETTSVILLE, TN 37072-1709
(615) 851-5700
(615) 851-1611
Mailing address
116 S MAIN ST, GOODLETTSVILLE, TN 37072-1709
(615) 851-5700
(615) 851-1611
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
0000011542
TN
Other
Enumeration date
11/30/2015
Last updated
11/30/2015
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