Organization
ECKERD CORPORATION
Active
Other names
RITE AID PHARMACY 10896
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
4101 GIBSONIA ROAD, GIBSONIA, PA 15044
(724) 444-8600
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
PP415508L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1007308150136
MEDICAID DME
PA
05
—
1007308150136
—
PA
01
—
3975666
OTHER ID NUMBER
—
Enumeration date
09/26/2006
Last updated
11/26/2008
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