Organization
PERRY DRUG STORES INC AND SUBSIDIARIES
Active
Other names
RITE AID PHARMACY 04476
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER M ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
4350 DIXIE HIGHWAY, WATERFORD, MI 48329-3511
(248) 674-0466
Mailing address
200 NEWBERRY COMMONS, ETTERS, PA 17319
(717) 761-2633
(717) 975-8659
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
5301004498
MI
3336C0003X
Community/Retail Pharmacy
Primary
5301004498
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2341294
NCPDP
MI
05
—
2341294
—
MI
Enumeration date
08/12/2006
Last updated
10/27/2008
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