Eckerd Corporation

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

201003264 Issued in VA

Legal business name

ECKERD CORPORATION

Practice address

20825 Woodpecker Road
Ettrick, VA 23803-2573

Phone

(804) 520-0247

NPI assigned

Sep 22, 2006

Organization subpart

No

Name

Jennifer Zorek

Title

Manager Online Adjudication

Phone

(717) 975-5937

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

• RITE AID PHARMACY 11299 Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 11, 2011.

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318291200000",
    "number": "1861591091",
    "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": "20825 WOODPECKER ROAD",
            "city": "ETTRICK",
            "state": "VA",
            "postal_code": "238032573",
            "telephone_number": "804-520-0247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ECKERD CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2011-10-11",
        "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": "VA",
            "license": "201003264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4831005",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008510539",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RITE AID PHARMACY 11299",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Health Care Solutions-DME
• Padma Kanakamedala
• Tami Conner Medeiros
• Open Arms Family Services, Inc.
• Ronald E. Terry, DMD, PC

• All providers in Ettrick, VA
• Community/Retail Pharmacy in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2011; 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.