Perry Drug Stores Inc and Subsidiaries

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301003088 Issued in MI

Legal business name

PERRY DRUG STORES INC AND SUBSIDIARIES

Doing business as

Rite Aid Pharmacy 04339

Practice address

11743 15 Mile Road
Sterling Heights, MI 48312-5103

Phone

(586) 979-3100

NPI assigned

Aug 29, 2006

Last updated

Oct 27, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jennifer ZorekNPI 1205649464

Title

Manager Online Adjudication

Phone

(717) 975-5937

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• RITE AID PHARMACY 04339 Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jennifer M Zorek

  • Pharmacy Technician
  • Etters, PA
  • NPI 1205649464
  Authorized official Same address or phone
• Vera Bachuwa

  • Pharmacist
  • Sterling Heights, MI
  • NPI 1407565401
  NPD (past)
• Concetta Formica

  • Pharmacy Technician
  • Sterling Heights, MI
  • NPI 1588328116
  NPD (past)
• Divyeshkumar Patel, PHARM. D

  • Pharmacist
  • Sterling Heights, MI
  • NPI 1841581485
  NPD (past)
• Holly Sobczynski, PHARMD

  • Pharmacist
  • Sterling Heights, MI
  • NPI 1124330931
  NPD (past)

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225065600000",
    "number": "1699884114",
    "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": "11743 15 MILE ROAD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483125103",
            "telephone_number": "586-979-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERRY DRUG STORES INC AND SUBSIDIARIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2008-10-27",
        "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": "5301003088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2309828",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2309828",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RITE AID PHARMACY 04339",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katia Pereira Dos Santos Weiss
• Periodontal Specialties
• Vinoth Periyasamy, MPT
• Julia Elizabeth Perks
• Spencer William Perri, LMT
• Perry Drug Stores Inc and Subsidiaries (Rite Aid Pharmacy 04389)
• Barbara Jean Perry, OTRL
• Paul F Perse, OD
• Personal Home Care Medical Equipment
• Perspectives of Troy, P.C.

• Community/Retail Pharmacy in Sterling Heights, MI
• Providers in Sterling Heights, 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 Oct 27, 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.