Rite Aid Pharmacy

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

0000011542 Issued in TN

Legal business name

RITE AID PHARMACY

Practice address

116 S Main St
Goodlettsville, TN 37072-1709

Phone

(615) 851-5700

Fax

(615) 851-1611

NPI assigned

Nov 30, 2015

Last updated

Nov 30, 2015By 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

Simon Igho Idiare

Title

Staff Pharmacist

Phone

(615) 852-6133

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1448841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448841600000",
    "number": "1265806350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 S MAIN ST",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370721709",
            "telephone_number": "615-851-5700",
            "fax_number": "615-851-1611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 S MAIN ST",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370721709",
            "telephone_number": "615-851-5700",
            "fax_number": "615-851-1611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RITE AID PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-30",
        "last_updated": "2015-11-30",
        "status": "A",
        "authorized_official_last_name": "IDIARE",
        "authorized_official_first_name": "SIMON",
        "authorized_official_middle_name": "IGHO",
        "authorized_official_title_or_position": "STAFF PHARMACIST",
        "authorized_official_telephone_number": "615-852-6133"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "TN",
            "license": "0000011542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Maintenance Organization in Goodlettsville, TN
• Providers in Goodlettsville, TN by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2015; 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.