Organization Active NPI

Thrifty Payless Inc

Doing business as Rite Aid Pharmacy 05678

  • Community/Retail Pharmacy
  • Coachella, CA
National Provider Identifier
1083723514
Registry record updated Sep 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY42419 Issued in CA
Legal business name
THRIFTY PAYLESS INC
Doing business as
Rite Aid Pharmacy 05678
Practice address
51101 Cesar Chavez St
Coachella, CA 92236-1560
Phone
(760) 398-0833
NPI assigned
Aug 29, 2006
Last updated
Sep 6, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2019

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

Authorized official

Name
Jennifer ZorekNPI 1205649464
Title
Manager Online Adjudication
Phone
(717) 975-5937

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Community/Retail Pharmacy 3336C0003X PHY42419 CA Primary

Addresses

Primary practice location

51101 Cesar Chavez St
Coachella, CA 92236-1560

Mailing address

200 Newberry Commons
Etters, PA 17319-9363
Phone (717) 761-2633

Other identifiers 2

IdentifierTypeStateIssuer
PHA424190MedicaidCA
0522210OtherOTHER ID NUMBER

Other names 1

  • RITE AID PHARMACY 05678 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110309000350 CA Part B Supplier - Mass Immunization (Roster Biller Only) 7719979095 This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Locations

51101 Harrison St
Coachella, CA 92236
Phone (760) 398-0833

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567728000000",
    "number": "1083723514",
    "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": "51101 CESAR CHAVEZ ST",
            "city": "COACHELLA",
            "state": "CA",
            "postal_code": "922361560",
            "telephone_number": "760-398-0833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THRIFTY PAYLESS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2019-09-06",
        "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": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY42419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA424190",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "0522210",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RITE AID PHARMACY 05678",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "RITE AID PHARMACY 05678",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coachella, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2019; 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.