Organization
LANE DRUG CO
Active
Other names
Rite Aid Pharmacy 02403
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
875 LEXINGTON AVENUE, MANSFIELD, OH 44907-1945
(419) 756-8329
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
—
OH
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0732256
—
OH
01
—
3651999
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/31/2006
Last updated
07/12/2011
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