Organization
RITE AID OF CONNECTICUT INC
Active
Other names
RITE AID PHARMACY 00576
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
605 NORTH COLONY ROAD, WALLINGFORD, CT 06492-3109
(203) 265-3600
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
1059
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004046207
—
CT
01
—
004060596
MEDICAID DME
CT
01
—
0701880
NCPDP
—
Enumeration date
08/30/2006
Last updated
02/10/2012
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