Rite Aid of New York Inc
Organization Active NPI Community/Retail Pharmacy · Northville, NY
NPI 1164531620 · NPPES record last updated Jan 4, 2012
Key facts
- NPI
- 1164531620
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 021816 (NY)
- Legal business name
- RITE AID OF NEW YORK INC
- Practice address
- 212 North Main Street
Northville, NY 12134-3550 - Phone
- (518) 863-6524
- NPI assigned
- Aug 29, 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Community/Retail Pharmacy | 3336C0003X | 021816 | NY | Yes |
Addresses
Primary practice location
212 North Main Street
Northville, NY 12134-3550
Mailing address
200 Newberry Commons
Etters, PA 17319-9363
Phone (717) 761-2633
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01424973 | Medicaid | NY | |
| 3335090 | Other | OTHER ID NUMBER |
Other names
- RITE AID PHARMACY 03524
Other providers in Northville, NY
- Thomas J Milko
- Frederick R Myers
- Victor Nikolsky
- Northville Central School District
- Joan Victoria Rimkunas
- St. Mary'S Healthcare
- Erica Lynn Tomlinson
- Cynthia Theresa Troia
- Walgreen Co
- Wellness in Motion Physical Therapy PLLC
All providers in Northville, 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 Jan 4, 2012. 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.