Edc Drug Stores Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

8757 Issued in NC

Legal business name

EDC DRUG STORES INC

Doing business as

RITE AID PHARMACY 11384

Practice address

12225 Capital Boulevard
Wake Forest, NC 27587-6200

Phone

(919) 556-2905

NPI assigned

Sep 22, 2006

Organization subpart

No

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

Authorized official

Name

Jennifer M Zorek

Title

Manager Online Adjudication

Phone

(717) 975-5937

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• RITE AID PHARMACY 11384 Doing business as

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501804800000",
    "number": "1194824334",
    "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": "12225 CAPITAL BOULEVARD",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275876200",
            "telephone_number": "919-556-2905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDC DRUG STORES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2017-08-04",
        "status": "A",
        "authorized_official_last_name": "ZOREK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "M",
        "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": "NC",
            "license": "8757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DME",
            "identifier": "7702386",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0929784",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "3426283",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RITE AID PHARMACY 11384",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelsey Lynn Dyer, NP
• Stacey Dyjewski, LCMHCS
• Dynamic Healthcare Solutions, Inc.
• Mackenzie Edwards Dziedzic, OD
• Derek Paul Easley, LCSW
• Edmond W Suh DDS PA
• Rizza Magbuhat Edradan, CSR, RDN, LDN
• Prina Patel Edralin, FNP-BC
• Clyde Richard Edwards, PA-C
• Sarah Kiefer Edwards

• Community/Retail Pharmacy in Wake Forest, NC
• Providers in Wake Forest, NC by specialty
• Community/Retail Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2017; 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.