Organization
ECKERD CORPORATION
Active
Other names
RITE AID PHARMACY 10442
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
695 DELSEA DRIVE NORTH, GLASSBORO, NJ 08028-1447
(856) 863-0695
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
28RS00500700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3136137
OTHER ID NUMBER
—
05
—
6366007
—
NJ
01
—
6366015
MEDICAID DME
NJ
Enumeration date
09/22/2006
Last updated
08/02/2011
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