Rite Aid of New York Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

023662 Issued in NY

Legal business name

RITE AID OF NEW YORK INC

Practice address

87 Main Street
Massena, NY 13662-1972

Phone

(315) 769-3484

NPI assigned

Aug 29, 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 2

Other names 1

• RITE AID PHARMACY 04998 Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325635200000",
    "number": "1154430619",
    "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": "87 MAIN STREET",
            "city": "MASSENA",
            "state": "NY",
            "postal_code": "136621972",
            "telephone_number": "315-769-3484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RITE AID OF NEW YORK INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2012-01-04",
        "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": "NY",
            "license": "023662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01827141",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "3342336",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RITE AID PHARMACY 04998",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nor Hasiah Ramli, MD
• Michelle W Ramsdell, CCC/SLP
• Randal J Place
• Kim M Reynolds
• Triston Riley, PA-C
• River Park Family Medicine, PC
• Diane E Roberts
• Roxanne Annette Roberts, FNP
• Nancy Marie Robideau, RN
• Jo Ann Roehm, LPN

• Community/Retail Pharmacy in Massena, NY
• Providers in Massena, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; 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.