Perry Drug Stores Inc and Subsidiaries

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

4482 Issued in MI

Legal business name

PERRY DRUG STORES INC AND SUBSIDIARIES

Doing business as

Rite Aid Pharmacy 04471

Practice address

1020 East Hill Road
Grand Blanc, MI 48439-4803

Phone

(810) 232-4111

NPI assigned

Aug 29, 2006

Last updated

Mar 16, 2009By 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

Jennifer ZorekNPI 1205649464

Title

Manager Online Adjudication

Phone

(717) 975-5937

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• RITE AID PHARMACY 04471 Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jennifer M Zorek

  • Pharmacy Technician
  • Etters, PA
  • NPI 1205649464
  Authorized official Same address or phone
• Rebecca V Misura

  • Pharmacy Technician
  • Grand Blanc, MI
  • NPI 1497326144
  NPD (past)
• Lynette Ann Sheyachich

  • Pharmacy Technician
  • Grand Blanc, MI
  • NPI 1851092274
  NPD (past)
• Raneem Shukairy

  • Pharmacist
  • Grand Blanc, MI
  • NPI 1326712522
  NPD (past)
• Pamela Thibodeau, RPH

  • Pharmacist
  • Grand Blanc, MI
  • NPI 1194014076
  NPD (past)

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237161600000",
    "number": "1386753838",
    "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": "1020 EAST HILL ROAD",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484394803",
            "telephone_number": "810-232-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERRY DRUG STORES INC AND SUBSIDIARIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2009-03-16",
        "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": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "4482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2341270",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2341270",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RITE AID PHARMACY 04471",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Roman Permyakov, DO
• Eileen Joe'L Perrigo, PHYSICAL THERAPIST
• Chelsea Perrotta, LPTA
• Keely Perrotta
• Perry Drug Stores Inc and Subsidiaries (Rite Aid Pharmacy 04319)
• Perry Drug Stores Inc and Subsidiaries (Rite Aid Pharmacy 04441)
• Personalized Family Care PLC
• Kathleen Ann Peshke, MS, RD, CDE
• Kotrina Peterson
• Natilly Peterson

• Community/Retail Pharmacy in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2009; 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.