Organization
RITE AID OF PENNSYLVANIA, LLC
Active
Other names
RITE AID Pharmacy 07832
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
4155 EWALT ROAD, GIBSONIA, PA 15044-9537
(724) 449-8080
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
PP481681
PA
3336C0003X
Community/Retail Pharmacy
Primary
PP481681
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1007292981104
MEDICAID DME
PA
05
—
1007292981104
—
PA
01
—
3987700
NCPDP
PA
Enumeration date
01/16/2007
Last updated
07/30/2020
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