Perry Drug Stores Inc and Subsidiaries

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301003288 Issued in MI

Legal business name

PERRY DRUG STORES INC AND SUBSIDIARIES

Doing business as

Rite Aid Pharmacy 04382

Practice address

2910 Ashman Street
Midland, MI 48640-4448

Phone

(989) 631-0700

NPI assigned

Jul 31, 2006

Last updated

Oct 17, 2017By 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 04382 Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

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
• Kaitlin Rose Farling, RN

  • Registered Nurse
  • Midland, MI
  • NPI 1043890486
  NPD (past)
• Mark Daniel Horton, RPH

  • Pharmacist
  • Midland, MI
  • NPI 1902925811
  NPD (past)
• Julia Ann Lauleess, R.PH.

  • Pharmacist
  • Midland, MI
  • NPI 1508992736
  NPD (past)
• Karman Norris

  • Pharmacy Technician
  • Midland, MI
  • NPI 1104490440
  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508198400000",
    "number": "1407862709",
    "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": "2910 ASHMAN STREET",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486404448",
            "telephone_number": "989-631-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERRY DRUG STORES INC AND SUBSIDIARIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2017-10-17",
        "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": "5301003288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2331027",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "2331027",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RITE AID PHARMACY 04382",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Samuel John Penkala, OTRL
• Courtney Pennington
• Danita Lucette Peoples-Peterson, MD
• Kendall Rose Perdue
• Ladd Herbert Perreault
• Shontelle Perry
• Personal Assistance Options
• Personal Assistance Options, Inc
• Perspectives Psychological Associates of Midmichigan LLC
• James Persyn

• Community/Retail Pharmacy in Midland, MI
• Providers in Midland, 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 Oct 17, 2017; 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.