Rite Aid of Michigan Inc

Key facts

NPI

1619086170

Entity type

Organization (NPI type 2)

Primary specialty

Community/Retail Pharmacy 3336C0003X

License

5301005768 (MI)

Legal business name

RITE AID OF MICHIGAN INC

Practice address

3939 South Lapeer Road
Metamora, MI 48455-8950

Phone

(810) 678-2331

NPI assigned

Aug 29, 2006

Organization subpart

No

Authorized official

Name

Jennifer Zorek

Title

Manager Online Adjudication

Phone

(717) 975-5937

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Julianne Marie Lentz, RPH Pharmacist · Metamora, MI · NPI 1588955629
  NPD (past)
• Dalton Thomas Raymond, PHARMACY IMMUNIZER Pharmacy Technician · Metamora, MI · NPI 1083375265
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in MI

Medicare enrollment records

National Provider Directory

Locations

Specialties & licenses

Addresses

Other identifiers

Other names

• RITE AID PHARMACY 03356 Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 17, 2009.

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239926400000",
    "number": "1619086170",
    "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": "3939 SOUTH LAPEER ROAD",
            "city": "METAMORA",
            "state": "MI",
            "postal_code": "484558950",
            "telephone_number": "810-678-2331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RITE AID OF MICHIGAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2009-04-17",
        "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": "MI",
            "license": "5301005768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2350205",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2350205",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RITE AID PHARMACY 03356",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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All providers in Metamora, MI · Community/Retail Pharmacy in Michigan