Eckerd Corporation

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

ECKERD CORPORATION

Practice address

5335 West Genesee Street
Suite 20
Camillus, NY 13031-2265

Phone

(315) 487-0435

NPI assigned

Oct 11, 2006

Organization subpart

No

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

Authorized official

Name

Jenni Zorek

Title

Manager Ol Adjudication

Phone

(717) 975-5937

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Rite Aid Pharmacy 10733 Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317254400000",
    "number": "1619065034",
    "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": "5335 WEST GENESEE STREET",
            "address_2": "SUITE 20",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130312265",
            "telephone_number": "315-487-0435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ECKERD CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2011-09-29",
        "status": "A",
        "authorized_official_last_name": "ZOREK",
        "authorized_official_first_name": "JENNI",
        "authorized_official_title_or_position": "MANAGER OL 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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DME",
            "identifier": "00479218",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3327827",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00479218",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rite Aid Pharmacy 10733",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Camillus, NY
• Providers in Camillus, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2011; 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.