Organization
RITE AID OF PENNSYLVANIA LLC
Active
Other names
RITE AID PHARMACY 06742
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (SR MANAGER PROVIDER ENROLLMENT)
(717) 975-5937
Entity
Organization
Contact information
Practice address
94 JUNE DRIVE, ROARING SPRING, PA 16673
(814) 224-5553
(814) 224-5827
Mailing address
200 NEWBERRY COMMONS, ETTERS, PA 17319-9363
(717) 975-5937
(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
05
—
1007292981174
—
PA
01
—
6001022
NCPDP
PA
Enumeration date
09/05/2014
Last updated
08/19/2020
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