Organization
RITE AID OF NEW YORK INC
Active
Other names
RITE AID PHARMACY 07903
Organization subpart
No
Provider details
NPI number
Authorized official
JENNI ZOREK (MANAGER OL ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
9108 ROOSEVELT AVENUE, JACKSON HEIGHTS, NY 11372-7910
(718) 478-6078
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
027975
NY
3336C0003X
Community/Retail Pharmacy
Primary
027975
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02873861
MEDICAID DME
NY
05
—
02873861
—
NY
01
—
3351789
NCPDP
NY
Enumeration date
08/25/2006
Last updated
12/27/2011
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