Rite Aid of Pennsylvania LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP414746L Issued in PA

Legal business name

RITE AID OF PENNSYLVANIA LLC

Practice address

4530 North 5TH Street
Philadelphia, PA 19140-1423

Phone

(215) 455-7330

NPI assigned

Oct 13, 2006

Organization subpart

No

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

Addresses

Other identifiers 3

Other names 1

• RITE AID PHARMACY 03394 Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jean Claude Djelhi Yahot, PHARM. D

  • Pharmacist
  • Philadelphia, PA
  • NPI 1316251465
  NPD (past)
• Saji Mathew

  • Pharmacist
  • Philadelphia, PA
  • NPI 1891145504
  NPD (past)
• Christopher Pino, PHARM. D

  • Pharmacist
  • Norristown, PA
  • NPI 1194098913
  NPD (past)
• Christin Raju, PHARMD

  • Pharmacist
  • Philadelphia, PA
  • NPI 1679981823
  NPD (past)
• Jeffrey Syen, RPH

  • Pharmacist
  • Philadelphia, PA
  • NPI 1902124985
  NPD (past)
• Susanna Trevino

  • Pharmacy Technician
  • Philadelphia, PA
  • NPI 1881381408
  NPD (past)

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597190400000",
    "number": "1437249463",
    "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": "4530 NORTH 5TH STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191401423",
            "telephone_number": "215-455-7330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RITE AID OF PENNSYLVANIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "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": "PA",
            "license": "PP414746L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007292980266",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DME",
            "identifier": "1007292980266",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "3966302",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RITE AID PHARMACY 03394",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "RITE AID PHARMACY 03394",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rite Aid of Pennsylvania LLC
• Rite Aid of Pennsylvania LLC
• Rite Aid of Pennsylvania LLC
• Rite Aid of Pennsylvania LLC
• Rite Aid of Pennsylvania LLC
• Rite Aid of Pennsylvania LLC
• Rite Aid of Pennsylvania LLC
• Rite Aid of Pennsylvania LLC
• Rite Aid of Pennsylvania LLC
• Rite Aid of Pennsylvania LLC

• Community/Retail Pharmacy in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Community/Retail Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.