Organization
THRIFTY PAYLESS INC
Active
Other names
Rite Aid Pharmacy 05370
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
2336 NORTH COAST HIGHWAY, NEWPORT, OR 97365-1799
(541) 265-8596
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
6777
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139340
—
OR
01
—
3807089
OTHER ID NUMBER-COMMERCIAL NUMBER
—
01
—
500633566
MEDICAID DME
OR
Enumeration date
08/30/2006
Last updated
08/25/2011
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