Organization
RITE AID OF MARYLAND INC
Active
Other names
RITE AID PHARMACY 04005
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
12524 OCEAN GATEWAY, OCEAN CITY, MD 21842-9690
(410) 213-0159
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2134170
NCPDP
—
01
—
416091600
MEDICAID DME
MD
05
—
416092400
—
MD
Enumeration date
09/30/2008
Last updated
09/01/2011
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