Organization
RITE AID OF PENNSYLVANIA LLC
Active
Other names
Rite Aid Pharmacy 07833
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER OL ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
1390 SOUTH VALLEY FORGE ROAD, LANSDALE, PA 19446-4718
(215) 361-1759
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
PP481618L
PA
3336C0003X
Community/Retail Pharmacy
Primary
PP481618L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1007292981094
MEDICAID DME
PA
05
—
1007292981094
—
PA
01
—
3986392
NCPDP
PA
Enumeration date
07/20/2006
Last updated
08/19/2020
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