Maxi Drug South LP

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHA00295 Issued in RI

Legal business name

MAXI DRUG SOUTH LP

Doing business as

Rite Aid Pharmacy 10239

Practice address

1080 Bald Hill Road
Warwick, RI 02886-4202

Phone

(401) 822-0002

NPI assigned

Sep 22, 2006

Organization subpart

No

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

Authorized official

Name

Jennifer Zorek

Title

Manager Online Adjudication

Phone

(717) 975-5937

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• RITE AID PHARMACY 10239 Doing business as

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323734400000",
    "number": "1790884161",
    "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": "1080 BALD HILL ROAD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028864202",
            "telephone_number": "401-822-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXI DRUG SOUTH LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2011-12-13",
        "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": "RI",
            "license": "PHA00295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9010244",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "4102529",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RITE AID PHARMACY 10239",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Matthew K. Rocheleau, DO LLC
• Brianna Lee Mattis
• Katerina Elana Mauricio, RN
• Maxi Drug South LP (Rite Aid Pharmacy 10240)
• Maxi Drug South LP (Rite Aid Pharmacy 10242)
• Maxi Drug South LP (Rite Aid Pharmacy 10241)
• Maxillofacial Surgeons, LTD. (MSL Facial & Oral Surgery)
• Sophie May
• Todd Warren May, DO, MHS
• Jennifer Amy Maybaum, RPH

• Community/Retail Pharmacy in Warwick, RI
• Providers in Warwick, RI by specialty
• Community/Retail Pharmacy in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2011; 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.