Rite Aid of Michigan Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301006324 Issued in MI

Legal business name

RITE AID OF MICHIGAN INC

Doing business as

Rite Aid Pharmacy 03966

Practice address

902 North Cedar Street
Kalkaska, MI 49646-8473

Phone

(231) 258-2081

NPI assigned

Aug 29, 2006

Last updated

Apr 17, 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 Online Adjudication

Phone

(717) 975-5937

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• RITE AID PHARMACY 03966 Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 5

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
• Shawn Lee Grucella, CPHT

  • Pharmacy Technician
  • Kalkaska, MI
  • NPI 1144994088
  NPD (past)
• Brenton Michael Healan, PHARMACY TECHNICIAN

  • Pharmacy Technician
  • Traverse City, MI
  • NPI 1487315024
  NPD (past)
• Amanda May Reid

  • Pharmacy Technician
  • Kalkaska, MI
  • NPI 1114628088
  NPD (past)
• Nasrin Ronaghi

  • Pharmacist
  • Kalkaska, MI
  • NPI 1144862012
  NPD (past)

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239926400000",
    "number": "1912016486",
    "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": "902 NORTH CEDAR STREET",
            "city": "KALKASKA",
            "state": "MI",
            "postal_code": "496468473",
            "telephone_number": "231-258-2081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RITE AID OF MICHIGAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2009-04-17",
        "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": "5301006324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2354873",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2354873",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RITE AID PHARMACY 03966",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pursuit Physical Therapy
• R.B. Drugs, Inc. (Kal Drugs)
• Sarah Ann Ray, FNP-BC
• Amanda May Reid
• Matthew James Rider, PT, DPT, CMP
• Rite Aid Pharmacy
• Robert & Kimberly Molter Inc
• Nasrin Ronaghi
• Jordan Michelle Sanger
• Denine Roberta Schmitt, LMT

• Community/Retail Pharmacy in Kalkaska, MI
• Providers in Kalkaska, 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 17, 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.