Organization
LANE DRUG CO
Active
Other names
Rite Aid Pharmacy 02408
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
613 WEST MAIN STREET, LOUISVILLE, OH 44641-1335
(330) 875-1429
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
02154100
OH
3336C0003X
Community/Retail Pharmacy
Primary
02154100
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0732934
—
OH
01
—
3652042
NCPDP
OH
Enumeration date
08/08/2006
Last updated
07/12/2011
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