Organization
ECKERD CORPORATION
Active
Other names
Rite Aid Pharmacy 10733
Organization subpart
No
Provider details
NPI number
Authorized official
JENNI ZOREK (MANAGER OL ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
5335 WEST GENESEE STREET, SUITE 20, CAMILLUS, NY 13031-2265
(315) 487-0435
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
—
00479218
MEDICAID DME
NY
05
—
00479218
—
NY
01
—
3327827
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
10/11/2006
Last updated
09/29/2011
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