Rite Aid of Pennsylvania LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP413873L Issued in PA

Legal business name

RITE AID OF PENNSYLVANIA LLC

Practice address

1516 Jefferson Avenue
Bi Lo Plaza
Windber, PA 15963-1752

Phone

(814) 467-9168

NPI assigned

Oct 12, 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 01780 Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597017600000",
    "number": "1497844146",
    "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": "1516 JEFFERSON AVENUE",
            "address_2": "BI LO PLAZA",
            "city": "WINDBER",
            "state": "PA",
            "postal_code": "159631752",
            "telephone_number": "814-467-9168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RITE AID OF PENNSYLVANIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "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": "PP413873L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007292980607",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "3952997",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DME",
            "identifier": "1007292980607",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RITE AID PHARMACY 01780",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "RITE AID PHARMACY 01780",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Albert Bruce Pruchnic, D.M.D.
• Megan Nicole Ratosky, CRNP
• Renal Care Consultants, PC
• Matthew Thomas Repko, DPT
• Rite Aid
• Patrice Rizzo, PHARMD
• Courtney Ronan, CRNP
• Hailey Danella Sanders
• Nathaniel J Sann, CRNP
• Diosdado A Santiago, MD

• Community/Retail Pharmacy in Windber, PA
• Providers in Windber, 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 10, 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.