Organization
LANE DRUG CO
Active
Other names
Rite Aid Pharmacy 02347
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER M ZOREK (SR MANAGER THIRD PARTY ENROLLMENTS)
(717) 975-5937
Entity
Organization
Contact information
Practice address
1221 WEST HIGH STREET, BRYAN, OH 43506-1543
(419) 636-6142
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
02159150
OH
3336C0003X
Community/Retail Pharmacy
Primary
02159150
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0733022
—
OH
01
—
3651545
NCPDP
OH
Enumeration date
07/25/2006
Last updated
07/25/2014
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