Organization Active NPI

Rite Aid of Virginia Inc

  • Community/Retail Pharmacy
  • Hampton, VA
National Provider Identifier
1689697393
Registry record updated Aug 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
0201001979 Issued in VA
Legal business name
RITE AID OF VIRGINIA INC
Practice address
10 Willow Oaks Blvd
Suite #2
Hampton, VA 23669-1739
Phone
(757) 851-0660
NPI assigned
Jul 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2015

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

Authorized official

Name
Jennifer Zorek
Title
Sr Ma Nager Provider Enrollment
Phone
(717) 975-5937

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X 0201001979 VA Primary

Addresses

Primary practice location

10 Willow Oaks Blvd
Suite #2
Hampton, VA 23669-1739

Mailing address

200 Newberry Commons
Etters, PA 17319-9363
Phone (717) 761-2633

Other identifiers 2

IdentifierTypeStateIssuer
4822385OtherOTHER ID NUMBER
008516766MedicaidVA

Other names 1

  • RITE AID PHARMACY 03948 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050207000781 VA Part B Supplier - Mass Immunization (Roster Biller Only) 0244281293 This NPI is an additional NPI on the enrollment
Practice locations: Norfolk, VA; Portsmouth, VA; Richmond, VA; Scottsville, VA; Suffolk, VA; Virginia Beach, VA; Hopewell, VA; Newport News, VA…

National Provider Directory

National Provider Directory

Locations

10 Willow Oaks Blvd
Ste 2
Hampton, VA 23669
Phone (757) 851-0660

10 Willow Oaks Blvd
Hampton, VA 23669
Phone (757) 851-0660

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439942400000",
    "number": "1689697393",
    "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": "10 WILLOW OAKS BLVD",
            "address_2": "SUITE #2",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236691739",
            "telephone_number": "757-851-0660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RITE AID OF VIRGINIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2015-08-19",
        "status": "A",
        "authorized_official_last_name": "ZOREK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "SR MA NAGER PROVIDER ENROLLMENT",
        "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": "VA",
            "license": "0201001979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "4822385",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008516766",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RITE AID PHARMACY 03948",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hampton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2015; 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.