Organization
THRIFTY PAYLESS INC
Active
Other names
RITE AID PHARMACY 05696
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
11673 CHERRY AVENUE, SOUTHRIDGE PLAZA, FONTANA, CA 92337-0141
(909) 357-2031
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
PHY42618
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0527068
OTHER ID NUMBER
—
05
—
PHA426180
—
CA
Enumeration date
08/29/2006
Last updated
10/12/2011
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