Organization
RITE AID OF VIRGINIA INC
Active
Other names
Rite Aid Pharmacy 06762
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (SR MANAGER PROVIDER ENROLLMENT)
(717) 975-5937
Entity
Organization
Contact information
Practice address
13554 CARROLLTON BLVD, CARROLLTON, VA 23314-3210
(757) 238-9401
(757) 238-9406
Mailing address
200 NEWBERRY CMNS, ETTERS, PA 17319-9363
(717) 975-5937
(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
05
—
1467995167
—
VA
01
—
4847589
NCPDP
—
01
—
P00920219
RR PTAN #
VA
Enumeration date
11/29/2016
Last updated
08/08/2017
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