Organization
EDC DRUG STORES INC
Active
Other names
RITE AID PHARMACY 11369
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
11360 US HIGHWAY 70 WEST, CLAYTON, NC 27520-2206
(919) 553-0144
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
8607
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0515478
—
NC
01
—
3420899
NCPDP
—
01
—
7702347
MEDICAID DME
NC
Enumeration date
09/22/2006
Last updated
08/14/2017
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