Organization
RITE AID OF MAINE INC
Active
Other names
Rite Aid Pharmacy 04132
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
279 MAIN STREET, SOUTH PORTLAND, ME 04106-2629
(207) 741-2260
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
PH50000956
ME
3336C0003X
Community/Retail Pharmacy
Primary
PH50000956
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2005709
NCPDP
ME
05
—
2005709
—
ME
Enumeration date
11/13/2006
Last updated
08/26/2011
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