Rite Aid of Pennsylvania LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP413498L Issued in PA

Legal business name

RITE AID OF PENNSYLVANIA LLC

Doing business as

RITE AID PHARMACY 00857

Practice address

169 W Lancaster Ave
Ardmore, PA 19003-1401

Phone

(610) 649-7150

NPI assigned

Oct 12, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jennifer Zorek

Title

Manager Online Adjudication

Phone

(717) 975-5937

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• RITE AID PHARMACY 00857 Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Tax ID family

Rite Aid Pharm 19832 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Rite Aid of Pennsylvania LLC

  • Community/Retail Pharmacy
  • Etters, PA
  • NPI 1386822336
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596758400000",
    "number": "1023107760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NEWBERRY COMMONS",
            "city": "ETTERS",
            "state": "PA",
            "postal_code": "173199363",
            "telephone_number": "717-761-2633",
            "fax_number": "717-975-8659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 W LANCASTER AVE",
            "city": "ARDMORE",
            "state": "PA",
            "postal_code": "190031401",
            "telephone_number": "610-649-7150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RITE AID OF PENNSYLVANIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A",
        "authorized_official_last_name": "ZOREK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "MANAGER ONLINE ADJUDICATION",
        "authorized_official_telephone_number": "717-975-5937"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP413498L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "3908778",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DME",
            "identifier": "1007292980781",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007292980781",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RITE AID PHARMACY 00857",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "RITE AID PHARMACY 00857",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Erica Ricciardi
• Michele Rice, MS, LPC
• Eric Ricefield, DPM
• Corey Richards
• Elizabeth R. Richman, PH.D.
• Katherine Jayne Robbins
• Robert Schwarz, PSYD,PC
• Roberts Pharmacy
• Tristan Robinson, PH.D.
• Thomas Rocca

• Community/Retail Pharmacy in Ardmore, PA
• Providers in Ardmore, PA by specialty
• Community/Retail Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.