Organization Active NPI

Rite Aid of Pennsylvania LLC

  • Community/Retail Pharmacy
  • Pittsburgh, PA
National Provider Identifier
1346621802
Registry record updated Oct 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
RITE AID OF PENNSYLVANIA LLC
Practice address
100 Forbes Avenue
Suite 100
Pittsburgh, PA 15233-1234
Phone
(717) 761-2633
NPI assigned
Jun 10, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2020

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

Authorized official

Name
Jennifer Zorek
Title
Sr Ma Nager Provider Enrollment
Phone
(717) 975-5937

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

100 Forbes Avenue
Suite 100
Pittsburgh, PA 15233-1234

Mailing address

200 Newberry Commons
Etters, PA 17319-9363
Phone (717) 975-5937

Other identifiers 2

IdentifierTypeStateIssuer
6002353OtherNCPDP
1007292981178MedicaidPA

Other names 1

  • Rite Aid Pharmacy 06712 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050607000800 PA Part B Supplier - Mass Immunization (Roster Biller Only) 1355384785 This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Locations

100 Forbes Ave
Ste 100
Pittsburgh, PA 15222
Phone (412) 338-8614

NPI Registry JSON

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

{
    "created_epoch": "1433894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601856000000",
    "number": "1346621802",
    "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": "717-975-5937",
            "fax_number": "717-975-8659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 FORBES AVENUE",
            "address_2": "SUITE 100",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152331234",
            "telephone_number": "717-761-2633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RITE AID OF PENNSYLVANIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-10",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A",
        "authorized_official_last_name": "ZOREK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "SR MA NAGER PROVIDER ENROLLMENT",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "6002353",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007292981178",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rite Aid Pharmacy 06712",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rite Aid Pharmacy 06712",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pittsburgh, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; 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.