Organization
THRIFTY PAYLESS INC
Active
Other names
Rite Aid Pharmacy 05287
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
230 KELSO DRIVE, RIVERWAY PLAZA, KELSO, WA 98626-3112
(360) 577-2693
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
262010404292
WA
3336C0003X
Community/Retail Pharmacy
Primary
262010404292
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165036
—
OR
01
—
4922236
NCPDP
WA
01
—
6017040
MEDICAID DME
WA
05
—
6017040
—
WA
Enumeration date
07/23/2006
Last updated
12/16/2011
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