NPIMap

Organization Active NPI

Rite Aid of Connecticut Inc

Doing business as Rite Aid Pharmacy 02089

  • Community/Retail Pharmacy
  • Waterbury, CT
National Provider Identifier
1467561746
Registry record updated Feb 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PCY01696 Issued in CT
Legal business name
RITE AID OF CONNECTICUT INC
Doing business as
Rite Aid Pharmacy 02089
Practice address
1030 Wolcott Street
Waterbury, CT 06705-1316
Phone
(203) 754-3636
NPI assigned
Aug 30, 2006
Last updated
Feb 10, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2012

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

Authorized official

Name
Jennifer M ZorekNPI 1205649464
Title
Manager Online Adjudication
Phone
(717) 975-5937

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X PCY01696 CT Primary

Addresses

Primary practice location

1030 Wolcott Street
Waterbury, CT 06705-1316

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
004190790MedicaidCT
0718049OtherNCPDP
004226909OtherCTMEDICAID DME

Other names 1

  • RITE AID PHARMACY 02089 Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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.

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": "1328832000000",
    "number": "1467561746",
    "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": "1030 WOLCOTT STREET",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067051316",
            "telephone_number": "203-754-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RITE AID OF CONNECTICUT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2012-02-10",
        "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": "PCY01696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004190790",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "0718049",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DME",
            "identifier": "004226909",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RITE AID PHARMACY 02089",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.