Rite Aid of Michigan Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301006818 Issued in MI

Legal business name

RITE AID OF MICHIGAN INC

Doing business as

Rite Aid Pharmacy 01010

Practice address

13916 Southwest Bay Shore Drive
Traverse City, MI 49684-6264

Phone

(231) 946-7400

NPI assigned

Jul 22, 2006

Last updated

Apr 21, 2009By 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 Ol Adjudication

Phone

(717) 975-5937

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Rite Aid Pharmacy 01010 Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 7

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
• Stephen M Buck, R.PH.

  • Pharmacist
  • Traverse City, MI
  • NPI 1154611366
  NPD (past)
• Myron George Didyk, REGISTERED RPH

  • Pharmacist
  • Traverse City, MI
  • NPI 1063702751
  NPD (past)
• Lori S George

  • Pharmacist
  • Traverse City, MI
  • NPI 1336556430
  NPD (past)
• Brenton Michael Healan, PHARMACY TECHNICIAN

  • Pharmacy Technician
  • Traverse City, MI
  • NPI 1487315024
  NPD (past)
• Karl Frederick Johnson II, RPH

  • Pharmacist
  • Traverse City, MI
  • NPI 1124156484
  NPD (past)
• Jennifer L Lamb, RN

  • Registered Nurse
  • Traverse City, MI
  • NPI 1649851668
  NPD (past)

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240272000000",
    "number": "1851312854",
    "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": "13916 SOUTHWEST BAY SHORE DRIVE",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496846264",
            "telephone_number": "231-946-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RITE AID OF MICHIGAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2009-04-21",
        "status": "A",
        "authorized_official_last_name": "ZOREK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "MANAGER OL ADJUDICATION",
        "authorized_official_telephone_number": "717-975-5937"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MI",
            "license": "5301006818",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301006818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2358299",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2358299",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rite Aid Pharmacy 01010",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Donna Laureen Rinker, RN MSN BC-FNP
• David Ripper, MD
• Rising Star Wellness Center PLC
• Amber Ristow, FNP
• Rite Aid of Michigan Inc (Rite Aid Pharmacy 04276)
• Julie P Ritter, O.D.
• River of Life Chiropractic and Wellness PLLC
• RJMW, LLC (C.a.R.E.)
• RLK Investments, Inc (Comfort Keepers 615)
• RLK Investments, Inc. (Comfort Keepers)

• Community/Retail Pharmacy in Traverse City, MI
• Providers in Traverse City, 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 Apr 21, 2009; 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.