Organization
ECKERD CORPORATION
Active
Other names
RITE AID PHARMACY 11435
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
30 WARREN C COLEMAN BOULEVARD NORTH, CONCORD, NC 28027-8318
(704) 782-2142
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
8612
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0135764
—
NC
01
—
3420774
OTHER ID NUMBER-COMMERCIAL NUMBER
—
01
—
7702281
MEDICAID DME
NC
Enumeration date
09/26/2006
Last updated
01/11/2010
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