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Organization

ECKERD CORPORATION

Active
Other names
RITE AID PHARMACY 11081
Organization subpart
No

Provider details

NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization

Contact information

Practice address
556 UNION STREET, LUZERNE, PA 18709-1245
(570) 287-1700
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
PP413721L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1007308150098
MEDICAID DME
PA
05
1007308150098
PA
01
3949786
OTHER ID NUMBER
Enumeration date
09/22/2006
Last updated
11/22/2011
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