Organization
THRIFTY PAYLESS INC
Active
Other names
RITE AID PHARMACY 06515
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER M XOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
211 WEST BIRCH STREET, CALEXICO, CA 92231-2348
(760) 768-3169
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
48279
CA
3336C0003X
Community/Retail Pharmacy
Primary
48279
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5623889
NCPDP
AR
05
—
PHA482790
—
CA
Enumeration date
09/28/2006
Last updated
11/01/2011
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