Rite Aid of New York Inc
Organization Active NPI Community/Retail Pharmacy · New York, NY
NPI 1578672002 · NPPES record last updated Oct 6, 2011
Key facts
- NPI
- 1578672002
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 024542 (NY)
- Legal business name
- RITE AID OF NEW YORK INC
- Practice address
- 534 Hudson Street
New York, NY 10014-2663 - Phone
- (646) 486-1048
- NPI assigned
- Aug 29, 2006
- Organization subpart
- No
Authorized official
- Name
- Jennifer Zorek
- Title
- Manager Online Adjudication
- Phone
- (717) 975-5937
Practitioners 4
-
Momana Nasrin Badrul, RPH
-
Judie Marie Butler, RPH
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100820000438 | NY | Part B Supplier - Mass Immunization (Roster Biller Only) | 6800920273 |
National Provider Directory
Locations
534 Hudson St
New York, NY 10014
Phone (646) 486-1048
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Community/Retail Pharmacy | 3336C0003X | 024542 | NY | Yes |
Addresses
Primary practice location
534 Hudson Street
New York, NY 10014-2663
Mailing address
200 Newberry Commons
Etters, PA 17319-9363
Phone (717) 761-2633
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02043754 | Medicaid | NY | |
| 3307914 | Other | OTHER ID NUMBER |
Other names
- RITE AID PHARMACY 01225
Other providers in New York, NY
- Rite Aid of New York Inc
- Rite Aid of New York Inc
- Rite Aid of New York Inc
- Rite Aid of New York Inc
- Rite Aid of New York Inc
- Rite Aid of New York Inc
- Rite Aid of New York Inc
- Rite Aid of New York Inc
- Rite Aid of New York Inc
- Rite Aid of New York Inc
All providers in New York, NY · Community/Retail Pharmacy in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 6, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.