Organization
ECKERD CORPORATION
Active
Other names
RITE AID PHARMACY 11195
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER M ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
66 EAST GLENWOOD AVENUE, SMYRNA, DE 19977
(302) 653-6649
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
A30000747
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000774407
—
DE
01
—
0801870
OTHER ID NUMBER
—
Enumeration date
09/25/2006
Last updated
01/24/2012
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