Organization
THRIFTY PAYLESS INC
Active
Other names
RITE AID PHARMACY 06539
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER M ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
608 WEST STANLEY STREET, GRANITE FALLS, WA 98252-8476
(360) 691-4659
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4933063
NCPDP
—
05
—
6031975
—
WA
01
—
9062423
MEDICAID DME
WA
Enumeration date
09/03/2008
Last updated
12/16/2011
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