Organization
PERRY DRUG STORES INC AND SUBSIDIARIES
Active
Other names
RITE AID PHARMACY 04441
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
11609 SOUTH SAGINAW STREET, GRAND BLANC, MI 48439-1354
(810) 694-4983
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
5301004041
MI
3336C0003X
Community/Retail Pharmacy
Primary
5301004041
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2337738
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
2337738
—
MI
Enumeration date
08/29/2006
Last updated
06/01/2017
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