Organization
THRIFTY PAYLESS INC
Active
Other names
Rite Aid Pharmacy 05583
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
1292 BORDER AVENUE, CORONA, CA 92882-3801
(951) 735-1011
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
PHY42464
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0553796
OTHER ID NUMBER
—
01
—
PHA424640
MEDICAID DME
CA
05
—
PHA424640
—
CA
Enumeration date
08/30/2006
Last updated
10/12/2011
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