Organization
THRIFTY PAYLESS INC
Active
Other names
Rite Aid Pharmacy 06743
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (SR MANAGER PROVIDER ENROLLMENT)
(717) 975-5937
Entity
Organization
Contact information
Practice address
30551 GATEWAY PL, RANCHO MISSION VIEJO, CA 92694
(717) 975-5937
Mailing address
200 NEWBERRY CMNS, ETTERS, PA 17319-9363
(717) 975-5937
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
—
BH320A
FLU PTAN
CA
01
—
P00949662
RR FLU PTAN
CA
Enumeration date
07/17/2017
Last updated
07/25/2019
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