Organization
MAXI DRUG INC
Active
Other names
RITE AID PHARMACY 10392
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
1032 HOPE STREET, STAMFORD, CT 06907-2106
(203) 327-6822
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
1504
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004138922
—
CT
01
—
0715954
OTHER ID NUMBER
—
05
—
4138922
—
CT
Enumeration date
09/22/2006
Last updated
12/22/2008
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