Organization
MAXI DRUG NORTH INC
Active
Other names
RITE AID PHARMACY 10291
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
1303 WOODBURY AVENUE, PORTSMOUTH, NH 03801-3210
(603) 431-1580
Mailing address
200 NEWBERRY COMMONS, ETTERS, PA 17319-9363
(717) 761-2633
(717) 975-8659
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0622P
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
151030004
—
ME
01
—
3006740
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
30701959
—
NH
Enumeration date
09/25/2006
Last updated
10/12/2011
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