Organization
THRIFTY PAYLESS INC
Active
Other names
RITE AID PHARMACY 05340
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (SR MAANGER PROVIDER ENROLLMENT)
(717) 975-5937
Entity
Organization
Contact information
Practice address
448 NE HIGHWAY 99 W, MCMINNVILLE TOWN CENTER, MCMINNVILLE, OR 97128-2793
(503) 472-2133
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
6780
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139795
—
OR
01
—
269447
MEDICAID DME
OR
01
—
3805453
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/30/2006
Last updated
05/28/2015
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