Organization
GENOVESE DRUG STORES INC
Active
Other names
RITE AID PHARMACY 10383
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
215 FEDERAL ROAD, BROOKFIELD, CT 06804-2630
(203) 740-1005
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
1890
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004246808
—
CT
01
—
004263034
MEDICAID DME
CT
01
—
0719988
NCPDP
CT
Enumeration date
10/11/2006
Last updated
03/14/2012
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