NPIMap

Organization Active NPI

Rite Aid of Maryland Inc

  • Community/Retail Pharmacy
  • Baltimore, MD
National Provider Identifier
1376652727
Registry record updated Sep 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
P00701 Issued in MD
Legal business name
RITE AID OF MARYLAND INC
Practice address
4339 Ebenezer Road
Perry Hall Shopping Center
Baltimore, MD 21236-2143
Phone
(410) 529-6171
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2011

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

Authorized official

Name
Jennifer Zorek
Title
Manager Online Adjudication
Phone
(717) 975-5937

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X P00701 MD Primary

Addresses

Primary practice location

4339 Ebenezer Road
Perry Hall Shopping Center
Baltimore, MD 21236-2143

Mailing address

200 Newberry Commons
Etters, PA 17319-9363
Phone (717) 761-2633

Other identifiers 2

IdentifierTypeStateIssuer
470612900MedicaidMD
2102983OtherOTHER ID NUMBER

Other names 1

  • RITE AID PHARMACY 00383 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100122000312 MD Part B Supplier - Mass Immunization (Roster Biller Only) 6709928153 This NPI is an additional NPI on the enrollment
Practice locations: Edgewood, MD; Eldersburg, MD; Elkton, MD; Ellicott City, MD; Forest Hill, MD; Glen Burnie, MD; Ocean City, MD; Owings Mills, MD…

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315440000000",
    "number": "1376652727",
    "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": "4339 EBENEZER ROAD",
            "address_2": "PERRY HALL SHOPPING CENTER",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212362143",
            "telephone_number": "410-529-6171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RITE AID OF MARYLAND INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2011-09-08",
        "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": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "P00701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "470612900",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "2102983",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RITE AID PHARMACY 00383",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.