Organization
THRIFTY PAYLESS INC
Active
Other names
Rite Aid Pharmacy 05553
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
10823 ZELZAH AVENUE, BUILDING D, GRANADA HILLS, CA 91344-4433
(818) 360-8411
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
PHY42287
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0516039
OTHER ID NUMBER
—
05
—
BBBPHA422870
—
CA
01
—
PHA422870
MEDICAID DME
CA
Enumeration date
08/09/2006
Last updated
11/18/2011
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