Rite Aid of Virginia Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

RITE AID OF VIRGINIA INC

Doing business as

Rite Aid Pharmacy 06762

Practice address

13554 Carrollton Blvd
Carrollton, VA 23314-3210

Phone

(757) 238-9401

Fax

(757) 238-9406

NPI assigned

Nov 29, 2016

Last updated

Aug 8, 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

Sr Manager Provider Enrollment

Phone

(717) 975-5937

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Rite Aid Pharmacy 06762 Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Practitioners 3

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
• Jazmin Marie Dashiell

  • Pharmacy Technician
  • Carrollton, VA
  • NPI 1285336958
  NPD (past)
• Robert Faulkner, PHARM D

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Carrollton, VA
  • NPI 1295301141
  NPD (past)

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

{
    "created_epoch": "1480377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502150400000",
    "number": "1467995167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NEWBERRY CMNS",
            "city": "ETTERS",
            "state": "PA",
            "postal_code": "173199363",
            "telephone_number": "717-975-5937",
            "fax_number": "717-975-8659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13554 CARROLLTON BLVD",
            "city": "CARROLLTON",
            "state": "VA",
            "postal_code": "233143210",
            "telephone_number": "757-238-9401",
            "fax_number": "757-238-9406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RITE AID OF VIRGINIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-29",
        "last_updated": "2017-08-08",
        "status": "A",
        "authorized_official_last_name": "ZOREK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "SR MANAGER PROVIDER ENROLLMENT",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467995167",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR PTAN #",
            "identifier": "P00920219",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4847589",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rite Aid Pharmacy 06762",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Carrollton, VA
• Providers in Carrollton, VA by specialty
• Community/Retail Pharmacy in Virginia

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