Rite Aid Of Pennsylvania LLC
Pharmacy, Community/Retail Pharmacy in Carbondale, PA. Organization (NPI-2).
NPI number1710076468
StatusActive
Last updated in NPPESAug 12, 2020
Details
- NPI
- 1710076468
- Entity type
- Organization (NPI-2)
- Legal business name
- Rite Aid Of Pennsylvania LLC
- Organization subpart
- No
- Enumeration date
- Oct 12, 2006
- Certification date
- Aug 12, 2020
- Last updated
- Aug 12, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | PP414498L | PA | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – |
Other names
- Rite Aid Pharmacy 02768 (Doing Business As)
Practice location
54 North Main StreetCarbondale, PA 18407-1927
Phone 570-282-3431
Mailing address
200 Newberry CommonsEtters, PA 17319-9363
Phone 717-761-2633 · Fax 717-975-8659
Authorized official
Jennifer Zorek
Manager Online Adjudication
7179755937
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