Eckerd Corporation

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

201003254 Issued in VA

Legal business name

ECKERD CORPORATION

Doing business as

Rite Aid Pharmacy 11241

Practice address

4511 John Tyler Highway
Suite K
Williamsburg, VA 23185-2415

Phone

(757) 253-8003

NPI assigned

Sep 22, 2006

Last updated

Oct 10, 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 3

Other names 1

• RITE AID PHARMACY 11241 Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Practitioners 5

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
• April Alley

  • Pharmacist
  • Williamsburg, VA
  • NPI 1356850986
  NPD (past)
• Manish Thamman, RPH

  • Pharmacist
  • Williamsburg, VA
  • NPI 1386943082
  NPD (past)
• Denise M. Tidwell, RPH

  • Pharmacist
  • Portsmouth, VA
  • NPI 1376828640
  NPD (past)
• Madeline Quyen Nguyen, PHARM.D.

  • Pharmacist
  • Orlando, FL
  • NPI 1871978478
  NPD (past)

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318204800000",
    "number": "1245339480",
    "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": "4511 JOHN TYLER HIGHWAY",
            "address_2": "SUITE K",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231852415",
            "telephone_number": "757-253-8003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ECKERD CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2011-10-10",
        "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": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "VA",
            "license": "201003254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8511390",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4831663",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008511390",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RITE AID PHARMACY 11241",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eastern State Hospital (ESH Pharmacy)
• Eastern State Hospital
• Ebg Counseling LLC
• Bushra Ebneof
• Dede E Echitey, FNP
• Eckerd Corporation (Rite Aid Pharmacy 11918)
• Eckerd Corporation (Rite Aid Pharmacy 11242)
• Kristina F. Edmonds, OT
• Edward H Tiller PHD PC (Williamsburg Centre For Therapy)
• Lisa Edwards, MA CCC-SLP

• Community/Retail Pharmacy in Williamsburg, VA
• Providers in Williamsburg, VA by specialty
• Community/Retail Pharmacy in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.