Organization
RITE AID OF MICHIGAN INC
Active
Organization
RITE AID OF MICHIGAN INC
Active
Other names
Rite Aid Pharmacy 04300
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
47300 PONTIAC TRAIL, WIXOM, MI 48393-2551
(248) 960-0352
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
5301006541
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2356726
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
2356726
—
MI
Enumeration date
07/31/2006
Last updated
05/26/2009
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