Perry Drug Stores Inc and Subsidiaries

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

4055 Issued in MI

Legal business name

PERRY DRUG STORES INC AND SUBSIDIARIES

Doing business as

Rite Aid Pharmacy 04426

Practice address

25996 Gratiot Avenue
Roseville, MI 48066-4436

Phone

(586) 774-1070

NPI assigned

Aug 9, 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 04426 Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512604800000",
    "number": "1851301170",
    "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": "25996 GRATIOT AVENUE",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664436",
            "telephone_number": "586-774-1070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERRY DRUG STORES INC AND SUBSIDIARIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2017-12-07",
        "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": "4055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2337295",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "2337295",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RITE AID PHARMACY 04426",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pearle Vision Inc (Pearle Vision #C6801)
• Brenda Peck
• Melissa Penner Walker
• Ja'Mya Marshay Perkins
• Laura Perlmutter, LMT
• Ladonna Lillian Peters, DNP, AGACNP
• Camelia Petrisor, D.D.S.
• Pharmacy-N-Dollar Shop Inc
• Priscilla Pickett
• Luis Antonio Pires, MD

• Community/Retail Pharmacy in Roseville, MI
• Providers in Roseville, 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 7, 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.