Rite Aid

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

73011 Issued in CA

Legal business name

RITE AID

Practice address

446 Roseville SQ
Roseville, CA 95678-2808

Phone

(916) 784-1590

Fax

(916) 784-1728

NPI assigned

Aug 25, 2015

Organization subpart

No

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

Authorized official

Name

Bogdan Mandzyuk, PHARM.D.

Title

Pharmacist

Phone

(916) 533-3492

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1440460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440460800000",
    "number": "1093182172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 ROSEVILLE SQ",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956782808",
            "telephone_number": "916-784-1590",
            "fax_number": "916-784-1728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "446 ROSEVILLE SQ",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956782808",
            "telephone_number": "916-784-1590",
            "fax_number": "916-784-1728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RITE AID",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-25",
        "last_updated": "2015-08-25",
        "status": "A",
        "authorized_official_last_name": "MANDZYUK",
        "authorized_official_first_name": "BOGDAN",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "916-533-3492",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "73011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Roseville, CA
• Providers in Roseville, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.