Organization
ECKERD CORPORATION
Active
Other names
RITE AID PHARMACY 10470
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
100 BLACK HORSE PIKE, AUDUBON, NJ 08106-1950
(856) 546-2362
(856) 546-3732
Mailing address
200 NEWBERRY COMMONS, ETTERS, PA 17319-9363
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00487100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3135135
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
6084401
—
NJ
01
—
6084419
MEDICAID DME
NJ
Enumeration date
09/26/2006
Last updated
06/17/2009
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