Rite Aid of New York Inc
Organization Active NPI Community/Retail Pharmacy · Hancock, NY
NPI 1073602702 · NPPES record last updated Oct 6, 2011
Key facts
- NPI
- 1073602702
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 021391 (NY)
- Legal business name
- RITE AID OF NEW YORK INC
- Practice address
- 119 West Main Street
Hancock, NY 13783-1017 - Phone
- (607) 637-2887
- NPI assigned
- Oct 12, 2006
- Organization subpart
- No
Authorized official
- Name
- Jennifer Zorek
- Title
- Manager Online Adjudication
- Phone
- (717) 975-5937
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100820000438 | NY | Part B Supplier - Mass Immunization (Roster Biller Only) | 6800920273 | This NPI is an additional NPI on the enrollment |
National Provider Directory
Locations
119 W Main St
Hancock, NY 13783
Phone (607) 637-2887
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Community/Retail Pharmacy | 3336C0003X | 021391 | NY | Yes |
Addresses
Primary practice location
119 West Main Street
Hancock, NY 13783-1017
Mailing address
200 Newberry Commons
Etters, PA 17319-9363
Phone (717) 761-2633
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1007631000015 | Medicaid | PA | |
| 01346758 | Medicaid | NY | |
| 3323540 | Other | OTHER ID NUMBER |
Other names
- RITE AID PHARMACY 02749
Other providers in Hancock, NY
- Connor James Mario Mack
- Mohammad Zakaria Majeed
- Bette-Lou Mead
- Greggory Milk
- Tracie Marie Ostrander
- Joseph William Rossi
- Michael Peter Salmon
- Town of Hancock Volunteer Ambulance Corps Inc
- Walgreen Co
- Megan Wormuth
All providers in Hancock, NY · Community/Retail Pharmacy in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 6, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.