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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