Organization
THRIFTY PAYLESS INC
Active
Other names
RITE AID PHARMACY 05515
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
12541 SEAL BEACH BLVD., SEAL BEACH, CA 90740-3621
(562) 430-3323
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
PHY45803
CA
3336C0003X
Community/Retail Pharmacy
Primary
PHY45803
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0516053
OTHER ID NUMBER
—
05
—
PHA422890
—
CA
Enumeration date
08/09/2006
Last updated
05/02/2014
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