NPIMap

Organization Active NPI

Rite Aid of Michigan Inc

Doing business as Rite Aid Pharmacy 03520

  • Community/Retail Pharmacy
  • Sparta, MI
National Provider Identifier
1184634792
Registry record updated Oct 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301006007 Issued in MI
Legal business name
RITE AID OF MICHIGAN INC
Doing business as
Rite Aid Pharmacy 03520
Practice address
11 East Division Street
Sparta, MI 49345-1325
Phone
(616) 887-0600
NPI assigned
Aug 8, 2006
Last updated
Oct 2, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2008

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

Authorized official

Name
Jennifer M ZorekNPI 1205649464
Title
Manager Ol Adjduication
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 5301006007 MI
Community/Retail Pharmacy 3336C0003X 5301006007 MI Primary

Addresses

Primary practice location

11 East Division Street
Sparta, MI 49345-1325

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
2352564OtherMINCPDP
2352564MedicaidMI

Other names 1

  • Rite Aid Pharmacy 03520 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050902000356 MI Part B Supplier - Mass Immunization (Roster Biller Only) 0840222501 This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Locations

11 E Division St
Sparta, MI 49345
Phone (616) 887-0600

Practitioners & affiliated clinicians

Practitioners 7

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": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222905600000",
    "number": "1184634792",
    "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": "11 EAST DIVISION STREET",
            "city": "SPARTA",
            "state": "MI",
            "postal_code": "493451325",
            "telephone_number": "616-887-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RITE AID OF MICHIGAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2008-10-02",
        "status": "A",
        "authorized_official_last_name": "ZOREK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER OL ADJDUICATION",
        "authorized_official_telephone_number": "717-975-5937"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MI",
            "license": "5301006007",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301006007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2352564",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2352564",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rite Aid Pharmacy 03520",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sparta, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2008; 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.