Organization
ECKERD CORPORATION
Active
Other names
RITE AID PHARMACY 11305
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
115 BRUNSWICK SQUARE COURT, LAWRENCEVILLE, VA 23868-3815
(434) 848-4247
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
201002545
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008511918
—
VA
01
—
4831295
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/22/2006
Last updated
10/11/2011
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