Organization
RITE AID OF MICHIGAN INC
Active
Organization
RITE AID OF MICHIGAN INC
Active
Other names
RITE AID PHARMACY 04068
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER M ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
63033 VAN DYKE ROAD, WASHINGTON, MI 48095
(586) 752-8905
Mailing address
200 NEWBERRY COMMONS, ETTERS, PA 17319
(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
—
1619117405
MEDICAID DME
MI
05
—
1619117405
—
MI
01
—
2372554
NCPDP
MI
Enumeration date
03/06/2009
Last updated
05/29/2009
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