Active NPI
Maxi Drug Inc
- Community/Retail Pharmacy
- Milford, CT
National Provider Identifier
1376643700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 1159
- Legal business name
- MAXI DRUG INC
- Doing business as
- RITE AID PHARMACY 10367
- Practice address
- 1387 New Haven Avenue
Milford, CT 06460-8159 - Phone
- (203) 874-0845
- NPI assigned
- Sep 25, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jennifer M Zorek
- Title
- Manager Online Adjudication
- Phone
- (717) 975-5937
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Community/Retail Pharmacy | 3336C0003X | 1159 | CT | Primary |
Addresses
Primary practice location
1387 New Haven Avenue
Milford, CT 06460-8159
Mailing address
200 Newberry Commons
Etters, PA 17319-9363
Phone (717) 761-2633
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004244571 | Other | CT | MEDICAID DME |
| 0715790 | Other | NCPDP | |
| 004137023 | Medicaid | CT |
Other names 1
- RITE AID PHARMACY 10367
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200522000778 | CT | Part B Supplier - Pharmacy | 0042254898 |
11 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Bethel, CT; Cheshire, CT; Fairfield, CT; Hamden, CT; Milford, CT; Monroe, CT; North Branford, CT; Northford, CT… |
Other NPIs on the same Medicare enrollment 11
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Milford, CT
- NPI 1457122152
-
- Pharmacist
- Milford, CT
- NPI 1538455100
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1329091200000",
"number": "1376643700",
"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": "1387 NEW HAVEN AVENUE",
"city": "MILFORD",
"state": "CT",
"postal_code": "064608159",
"telephone_number": "203-874-0845"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MAXI DRUG INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-25",
"last_updated": "2012-02-13",
"status": "A",
"authorized_official_last_name": "ZOREK",
"authorized_official_first_name": "JENNIFER",
"authorized_official_middle_name": "M",
"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": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "CT",
"license": "1159",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID DME",
"identifier": "004244571",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "0715790",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004137023",
"state": "CT"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "RITE AID PHARMACY 10367",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Milford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2012; 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.