Rite Aid of Michigan Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301004483 Issued in MI

Legal business name

RITE AID OF MICHIGAN INC

Practice address

1950 West Centre Avenue
Portage, MI 49024-5334

Phone

(269) 321-0664

NPI assigned

Aug 8, 2006

Organization subpart

No

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

Authorized official

Name

Jennifer M Zorek

Title

Maanger Online Adjudication

Phone

(717) 975-5937

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• RITE AID Pharmacy 01822 Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 6

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

• Reginald Bebri

  • Pharmacy
  • Portage, MI
  • NPI 1316616287
  NPD (past)
• Jessica Erin Burley, RPH

  • Pharmacist
  • Portage, MI
  • NPI 1366567125
  NPD (past)
• Charles Michael Chucta

  • Pharmacist
  • Portage, MI
  • NPI 1518266386
  NPD (past)
• Charles Douglas Louisell, R.PH.

  • Pharmacist
  • Portage, MI
  • NPI 1306061510
  NPD (past)
• Jooheon Park, PHARMD

  • Pharmacist
  • Portage, MI
  • NPI 1811456767
  NPD (past)
• Sylvia A Wasson, PHARMD

  • Pharmacist
  • Portage, MI
  • NPI 1306417514
  NPD (past)

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222646400000",
    "number": "1619987419",
    "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": "1950 WEST CENTRE AVENUE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490245334",
            "telephone_number": "269-321-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RITE AID OF MICHIGAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2008-09-29",
        "status": "A",
        "authorized_official_last_name": "ZOREK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MAANGER ONLINE ADJUDICATION",
        "authorized_official_telephone_number": "717-975-5937"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MI",
            "license": "5301004483",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301004483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2341131",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2341131",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RITE AID Pharmacy 01822",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeffrey Joseph Riggs, D.D.S.
• Richard Riley
• Abby Rinderer
• Ripple Effects Inclusion Center
• Rise: Counseling Group and Holistic Wellness Center LLC
• David Ritzenthaler, PT
• Amanda Marie Ritzer, PA-C
• River of Life Counseling LLC
• Joanna A Rivera, MSW, LCSW
• Maria Jesus Rivera, COUNSELOR

• Community/Retail Pharmacy in Portage, MI
• Providers in Portage, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2008; 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.