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Organization

PERRY DRUG STORES INC AND SUBSIDIARIES

Active
Other names
RITE AID PHARMACY 04487
Organization subpart
No

Provider details

NPI number
Authorized official
JENNIFER ZOREK (SR MANAGER PROVIDER ENROLLMENT)
(717) 975-5937
Entity
Organization

Contact information

Practice address
3050 UNION LAKE ROAD, COMMERCE TOWNSHIP, MI 48382-4509
(248) 363-4392
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
3405
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2327662
OTHER ID NUMBER-COMMERCIAL NUMBER
05
2327662
MI
Enumeration date
08/29/2006
Last updated
07/16/2015
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