Rite Aid of Michigan Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301006502 Issued in MI

Legal business name

RITE AID OF MICHIGAN INC

Doing business as

Rite Aid Pharmacy 04740

Practice address

1339 East Grand River Avenue
Portland, MI 48875-1629

Phone

(517) 647-4704

NPI assigned

Jul 27, 2006

Last updated

Oct 6, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jennifer ZorekNPI 1205649464

Title

Manager Online Adjudication

Phone

(717) 975-5937

Specialties & licenses 2

Addresses

Other names 1

• Rite Aid Pharmacy 04740 Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

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.

• Jennifer M Zorek

  • Pharmacy Technician
  • Etters, PA
  • NPI 1205649464
  Authorized official Same address or phone

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223251200000",
    "number": "1205850559",
    "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": "1339 EAST GRAND RIVER AVENUE",
            "city": "PORTLAND",
            "state": "MI",
            "postal_code": "488751629",
            "telephone_number": "517-647-4704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RITE AID OF MICHIGAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2008-10-06",
        "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": "MI",
            "license": "5301006502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rite Aid Pharmacy 04740",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Molly Kathryn Puglessi
• Randall J Riemer, OD, PLC (Riemer Eyecare)
• Stephanie Marie Ratliff-Putney, LMT
• Randall John Riemer, O.D.
• Ruby Riley
• Rite Aid Pharmacy
• Michelle Robydek, MA, LPC
• Anthony Lee Sands, PA-C
• Rachel Sands, RDN
• Michael W Schafer, M.D.

• Community/Retail Pharmacy in Portland, MI
• Providers in Portland, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.