NPIMap

Organization Active NPI

Perry Drug Stores Inc and Subsidiaries

  • Community/Retail Pharmacy
  • Troy, MI
National Provider Identifier
1093725541
Registry record updated Mar 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301000229 Issued in MI
Legal business name
PERRY DRUG STORES INC AND SUBSIDIARIES
Practice address
2971 West Maple Road
Troy, MI 48084-7032
Phone
(248) 288-4385
NPI assigned
Aug 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2009

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

Authorized official

Name
Jennifer Zorek
Title
Manager Ol Adjudication
Phone
(717) 975-5937

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 5301000229 MI
Community/Retail Pharmacy 3336C0003X 5301000229 MI Primary

Addresses

Primary practice location

2971 West Maple Road
Troy, MI 48084-7032

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
2303953OtherMINCPDP
2303953MedicaidMI

Other names 1

  • RITE AID PHARMACY 04305 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050614000979 MI Part B Supplier - Mass Immunization (Roster Biller Only) 3476597121 This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236729600000",
    "number": "1093725541",
    "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": "2971 WEST MAPLE ROAD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480847032",
            "telephone_number": "248-288-4385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERRY DRUG STORES INC AND SUBSIDIARIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2009-03-11",
        "status": "A",
        "authorized_official_last_name": "ZOREK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "MANAGER OL ADJUDICATION",
        "authorized_official_telephone_number": "717-975-5937"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MI",
            "license": "5301000229",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301000229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2303953",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2303953",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RITE AID PHARMACY 04305",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2009; 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.