Organization
RITE AID OF MARYLAND INC
Active
Other names
RITE AID PHARMACY 04917
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER MARIE ZOREK (SR MANAGER THIRD PARTY ENROLLMENTS)
(717) 975-5937
Entity
Organization
Contact information
Practice address
11011 MANKLIN CREEK ROAD, BERLIN, MD 21811-4010
(410) 641-5858
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
P01254
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
118100900
MEDICAID DME
MD
01
—
2123090
NCPDP
—
05
—
586602200
—
MD
Enumeration date
08/31/2006
Last updated
10/09/2012
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