Eckerd Corporation
Organization Active NPI Community/Retail Pharmacy · Derby, NY
NPI 1255430518 · NPPES record last updated Sep 29, 2011
Key facts
- NPI
- 1255430518
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 023882 (NY)
- Legal business name
- ECKERD CORPORATION
- Practice address
- 6939 Erie Road
Derby, NY 14047-9406 - Phone
- (716) 947-5066
- NPI assigned
- Sep 22, 2006
- Organization subpart
- No
Authorized official
- Name
- Jennifer Zorek
- Title
- Manager Online Adjudication
- Phone
- (717) 975-5937
Practitioners 8
-
Denise Clouse, PHARMACIST
-
Cory Joseph Coleman, RPH
-
Emily Rine, PHARM D
-
Alan Joseph Sailer, RPH.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100814000109 | NY | Part B Supplier - Mass Immunization (Roster Biller Only) | 4082699152 | This NPI is an additional NPI on the enrollment |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Community/Retail Pharmacy | 3336C0003X | 023882 | NY | Yes |
Addresses
Primary practice location
6939 Erie Road
Derby, NY 14047-9406
Mailing address
200 Newberry Commons
Etters, PA 17319-9363
Phone (717) 761-2633
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01505999 | Medicaid | NY | |
| 3354999 | Other | OTHER ID NUMBER |
Other names
- RITE AID PHARMACY 10810
Other providers in Derby, NY
- Tina Lyon Dell
- Dent Neurologic Group, LLP
- Eric Dibben
- Douglas D Hage MD PC
- Lauren R Dunaway
- Frederick Eckles Jr.
- Gwendolyn Eckles
- Michael Warren Fancher
- Julie M. Farrell
- Jennifer Foley
All providers in Derby, NY · Community/Retail Pharmacy in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.