Rite Aid of Michigan Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

4021 Issued in MI

Legal business name

RITE AID OF MICHIGAN INC

Doing business as

RITE AID PHARMACY 01521

Practice address

2130 Wealthy Street Southeast
Gaslight Village
Grand Rapids, MI 49506-3057

Phone

(616) 451-0711

NPI assigned

Jul 25, 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 01521 Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ralph David Martin, RPH

  • Pharmacist
  • Grand Rapids, MI
  • NPI 1881782076
  NPD (past)
• Joel Roudabush, RPH

  • Pharmacist
  • Grand Rapids, MI
  • NPI 1295025369
  NPD (past)
• Hue Ngoc Vuong, PHARM D

  • Pharmacist
  • Grand Rapids, MI
  • NPI 1710003819
  NPD (past)
• Victor S Wagner, PHD

  • Clinical Psychologist
  • Big Rapids, MI
  • NPI 1457383820
  NPD (past)

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223251200000",
    "number": "1811910722",
    "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": "2130 WEALTHY STREET SOUTHEAST",
            "address_2": "GASLIGHT VILLAGE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495063057",
            "telephone_number": "616-451-0711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RITE AID OF MICHIGAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2008-10-06",
        "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": "4021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "2337081",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2337081",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RITE AID PHARMACY 01521",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jonathan Tyler Ritchie
• Lauryn Ritchie
• Manasvi Pinnamaneni Ritchie, MD
• Rite Aid of Michigan Inc
• Rite Aid of Michigan Inc
• Candie Ritsema
• Crystal Ritsema, M.D.
• Danielle Ritsema, LLBSW
• Emily Ritsema, MD
• Erin Ritsema

• Community/Retail Pharmacy in Grand Rapids, MI
• Providers in Grand Rapids, 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 6, 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.