Perry Drug Stores Inc and Subsidiaries

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

3510 Issued in MI

Legal business name

PERRY DRUG STORES INC AND SUBSIDIARIES

Doing business as

Rite Aid Pharmacy 04365

Practice address

1970 Southfield Road
Lincoln Park, MI 48146-2248

Phone

(313) 386-6330

NPI assigned

Jul 31, 2006

Last updated

Dec 12, 2017By 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 04365 Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 3

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
• Ketan Dudhara, R PH.

  • Pharmacist
  • Lincoln Park, MI
  • NPI 1285757088
  NPD (past)
• Apoorva Chandrakant Pandit

  • Pharmacist
  • Lincoln Park, MI
  • NPI 1710120902
  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513036800000",
    "number": "1780690081",
    "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": "1970 SOUTHFIELD ROAD",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481462248",
            "telephone_number": "313-386-6330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERRY DRUG STORES INC AND SUBSIDIARIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2017-12-12",
        "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": "3510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "2328866",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2328866",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rite Aid Pharmacy 04365",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Lincoln Park, MI
• Providers in Lincoln Park, 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 Dec 12, 2017; 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.