Rite Aid of New York Inc
Organization Active NPI Community/Retail Pharmacy · Stamford, NY
NPI 1689714800 · NPPES record last updated Oct 7, 2011
Key facts
- NPI
- 1689714800
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 028236 (NY)
- Legal business name
- RITE AID OF NEW YORK INC
- Practice address
- 5 Lake Street
Stamford, NY 12167-1007 - Phone
- (607) 652-3675
- NPI assigned
- Feb 7, 2007
- Organization subpart
- No
Authorized official
- Name
- Jennifer Zorek
- Title
- Manager Online Adjudication
- Phone
- (717) 975-5937
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 | This NPI is an additional NPI on the enrollment |
National Provider Directory
Locations
5 Lake St
Stamford, NY 12167
Phone (607) 652-3675
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Community/Retail Pharmacy | 3336C0003X | 028236 | NY | Yes |
Addresses
Primary practice location
5 Lake Street
Stamford, NY 12167-1007
Mailing address
200 Newberry Commons
Etters, PA 17319-9363
Phone (717) 761-2633
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3352919 | Other | OTHER ID NUMBER | |
| 02900558 | Medicaid | NY |
Other names
- RITE AID PHARMACY 07873
Other providers in Stamford, NY
- Christy Odonnell
- Michael Oeser
- Jennifer Parker
- Ramon Mira Postrano Jr.
- Brian Reese
- Robert J. Connelly
- Rtacf LLC
- Rtrnc LLC
- Alice E Shockey
- Stamford Central School Dist 1
All providers in Stamford, 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 7, 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.