NPIMap

Organization Active NPI

Perry Drug Stores Inc and Subsidiaries

Doing business as Rite Aid Pharmacy 04592

  • Community/Retail Pharmacy
  • Clarkston, MI
National Provider Identifier
1891804357
Registry record updated Oct 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301005683 Issued in MI
Legal business name
PERRY DRUG STORES INC AND SUBSIDIARIES
Doing business as
Rite Aid Pharmacy 04592
Practice address
5789 Ortonville Road
Clarkston, MI 48346-2959
Phone
(248) 625-5271
NPI assigned
Aug 29, 2006
Last updated
Oct 27, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jennifer ZorekNPI 1205649464
Title
Manager Online Adjudication
Phone
(717) 975-5937

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Community/Retail Pharmacy 3336C0003X 5301005683 MI Primary

Addresses

Primary practice location

5789 Ortonville Road
Clarkston, MI 48346-2959

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
2349632OtherOTHER ID NUMBER COMMERCIAL NUMBER
2349632MedicaidMI

Other names 1

  • RITE AID PHARMACY 04592 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050614000979 MI Part B Supplier - Mass Immunization (Roster Biller Only) 3476597121 This NPI is an additional NPI on the enrollment
O20050819000067 MI Part B Supplier - Mass Immunization (Roster Biller Only) 9830129832 33 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Detroit, MI; Dowagiac, MI; Dearborn, MI; Farmington Hills, MI; Fenton, MI; Houghton Lake, MI; Livonia, MI; Mount Clemens, MI…

Other NPIs on the same Medicare enrollment 27

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 27

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225065600000",
    "number": "1891804357",
    "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": "5789 ORTONVILLE ROAD",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483462959",
            "telephone_number": "248-625-5271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERRY DRUG STORES INC AND SUBSIDIARIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2008-10-27",
        "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": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301005683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER COMMERCIAL NUMBER",
            "identifier": "2349632",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2349632",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RITE AID PHARMACY 04592",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clarkston, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.