Eckerd Corporation

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28RS00623300 Issued in NJ

Legal business name

ECKERD CORPORATION

Doing business as

Rite Aid Pharmacy 10425

Practice address

200 Wilson Avenue
Port Monmouth, NJ 07758-1228

Phone

(732) 495-4213

NPI assigned

Jun 30, 2006

Last updated

Aug 2, 2011By 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 identifiers 2

Other names 1

• RITE AID PHARMACY 10425 Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Eckerd Corporation

  dba Rite Aid Pharmacy 11175

  • Community/Retail Pharmacy
  • Bear, DE
  • NPI 1437258761

  4082699152

  Same PAC ID
• Eckerd Corporation

  dba Rite Aid Pharmacy 10546

  • Community/Retail Pharmacy
  • Carmel, NY
  • NPI 1457451809

  4082699152

  Same PAC ID
• Eckerd Corporation

  dba Rite Aid Pharmacy 10680

  • Community/Retail Pharmacy
  • Clifton Park, NY
  • NPI 1760581904

  4082699152

  Same PAC ID
• Eckerd Corporation

  dba Rite Aid Pharmacy 11268

  • Community/Retail Pharmacy
  • Virginia Beach, VA
  • NPI 1982703120

  4082699152

  Same PAC ID

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": "1151625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312243200000",
    "number": "1245268994",
    "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": "200 WILSON AVENUE",
            "city": "PORT MONMOUTH",
            "state": "NJ",
            "postal_code": "077581228",
            "telephone_number": "732-495-4213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ECKERD CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-30",
        "last_updated": "2011-08-02",
        "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": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RS00623300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001562",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "3145201",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RITE AID PHARMACY 10425",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Community Options, Inc.
• Daniel Deshong, ATC
• Craig Domanski, M.A., BCBA
• Drug Fair Group, Inc. (Drug Fair of Port Monmouth 48)
• Brianne Dwyer, RBT
• Jay Hochheiser, L.C.S.W.
• Home Stretch Consulting, LLC
• Horizon Mental Wellness LLC
• Christine Ibrahim, M.D.
• Yasmeen Jafry, MD

• Community/Retail Pharmacy in Port Monmouth, NJ
• Providers in Port Monmouth, NJ by specialty
• Community/Retail Pharmacy in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2011; 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.