Organization Active NPI

Thrifty Payless Inc

  • Community/Retail Pharmacy
  • Fortuna, CA
National Provider Identifier
1881703296
Registry record updated Oct 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY42498 Issued in CA
Legal business name
THRIFTY PAYLESS INC
Practice address
725 South Fortuna Boulevard
Redwood Village Shopping Center
Fortuna, CA 95540-3034
Phone
(707) 725-9314
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2011

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

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X PHY42498 CA Primary

Addresses

Primary practice location

725 South Fortuna Boulevard
Redwood Village Shopping Center
Fortuna, CA 95540-3034

Mailing address

200 Newberry Commons
Etters, PA 17319-9363
Phone (717) 761-2633

Other identifiers 2

IdentifierTypeStateIssuer
0571100OtherOTHER ID NUMBER
PHA424980MedicaidCA

Other names 1

  • RITE AID PHARMACY 06041 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110309000350 CA Part B Supplier - Mass Immunization (Roster Biller Only) 7719979095 This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Locations

725 S Fortuna Blvd
Fortuna, CA 95540
Phone (707) 725-9314

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318982400000",
    "number": "1881703296",
    "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": "725 SOUTH FORTUNA BOULEVARD",
            "address_2": "REDWOOD VILLAGE SHOPPING CENTER",
            "city": "FORTUNA",
            "state": "CA",
            "postal_code": "955403034",
            "telephone_number": "707-725-9314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THRIFTY PAYLESS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2011-10-19",
        "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": "CA",
            "license": "PHY42498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "0571100",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA424980",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RITE AID PHARMACY 06041",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fortuna, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.