Organization
GENOVESE DRUG STORES INC
Active
Other names
RITE AID PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
880 BOSTON POST ROAD, GUILFORD, CT 06437-2701
(203) 453-4319
(203) 458-1066
Mailing address
200 NEWBERRY COMMONS, ETTERS, PA 17319-9363
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1886
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004046348
MEDICAID DME
CT
05
—
004046397
—
CT
01
—
0701246
OTHER ID NUMBER
—
05
—
940004046397
—
CT
Enumeration date
09/22/2006
Last updated
06/25/2008
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