Organization
GENOVESE DRUG STORES INC
Active
Other names
Rite Aid Pharmacy 10543
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MNGR OL ADJDUICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
21B KNOLLS CRESCENT, BRONX, NY 10463-6301
(718) 432-3030
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
23435
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001775759
MEDICAID DME
NY
05
—
001775759
—
NY
01
—
3329352
NABP
—
Enumeration date
06/26/2006
Last updated
10/03/2011
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