Organization
GENOVESE DRUG STORES INC
Active
Other names
RITE AID PHARMACY 10647
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGERONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
33-37 HICKSVILLE ROAD, MASSAPEQUA, NY 11758
(516) 795-7211
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
02734
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001588994
MEDICAID DME
NY
05
—
001588994
—
NY
01
—
3307902
NABP
—
Enumeration date
07/04/2006
Last updated
12/02/2010
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