Organization
RITE AID OF MICHIGAN INC
Active
Other names
RITE AID Pharmacy 01822
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER M ZOREK (MAANGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
1950 WEST CENTRE AVENUE, PORTAGE, MI 49024-5334
(269) 321-0664
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
5301004483
MI
3336C0003X
Community/Retail Pharmacy
Primary
5301004483
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2341131
NCPDP
MI
05
—
2341131
—
MI
Enumeration date
08/08/2006
Last updated
09/29/2008
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