NPIMap

Organization Active NPI

Edc Drug Stores

Doing business as Rite Aid Pharmacy 11507

  • Community/Retail Pharmacy
  • Fayetteville, NC
National Provider Identifier
1700985900
Registry record updated Apr 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
8633 Issued in NC
Legal business name
EDC DRUG STORES
Doing business as
Rite Aid Pharmacy 11507
Practice address
3716 Morganton Rd
Fayetteville, NC 28303-4963
Phone
(910) 868-5103
NPI assigned
Sep 22, 2006
Last updated
Apr 25, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2013

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

Authorized official

Name
Jennifer M ZorekNPI 1205649464
Title
Sr Manager Third Party Enrollments
Phone
(717) 975-5937

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X 8633 NC Primary

Addresses

Primary practice location

3716 Morganton Rd
Fayetteville, NC 28303-4963

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
7702388OtherNCMEDICAID DME
3402574OtherNCPDP
0266023MedicaidNC

Other names 1

  • RITE AID PHARMACY 11507 Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366848000000",
    "number": "1700985900",
    "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": "3716 MORGANTON RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283034963",
            "telephone_number": "910-868-5103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDC DRUG STORES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2013-04-25",
        "status": "A",
        "authorized_official_last_name": "ZOREK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SR MANAGER THIRD PARTY ENROLLMENTS",
        "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": "NC",
            "license": "8633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DME",
            "identifier": "7702388",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "3402574",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0266023",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RITE AID PHARMACY 11507",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.