NPIMap

Organization Active NPI

PDS I Michigan Inc

Doing business as Rite Aid Corporation

  • Community/Retail Pharmacy
  • Etters, PA
National Provider Identifier
1912196759
Registry record updated Jan 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
PDS I MICHIGAN INC
Doing business as
Rite Aid Corporation
Practice address
200 Newberry Commons
Etters, PA 17319-9363
Phone
(717) 761-2633
NPI assigned
Oct 17, 2007
Last updated
Jan 21, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2019

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 NU Primary

Addresses

Primary practice location

200 Newberry Commons
Etters, PA 17319-9363

Mailing address

PO Box 371115
Pittsburgh, PA 15250-7115
Phone (717) 761-2633

Other names 1

  • RITE AID CORPORATION Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050725000709 MI Part B Supplier - Mass Immunization (Roster Biller Only) 1153358833 8 other NPIs on this enrollment
Practice locations: Ionia, MI; Ludington, MI; Manistee, MI; Petoskey, MI; Sault St Marie, MI; St Johns, MI; Traverse City, MI

Other NPIs on the same Medicare enrollment 8

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

National Provider Directory

National Provider Directory

Locations

936 E Ludington Ave
#4567
Ludington, MI 49431
Phone (231) 845-7332

1243 US Highway 31 S
Manistee, MI 49660
Phone (231) 723-9348

1243 US Highway 31 S
#4407
Manistee, MI 49660
Phone (231) 723-9438

1750 Gratiot Blvd
Marysville, MI 48040
Phone (810) 364-6200

630 W Mitchell St
#4410
Petoskey, MI 49770
Phone (231) 347-8282

2910 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 987-3663

109 N Whittemore St
Saint Johns, MI 48879
Phone (989) 224-2313

109 N Whittemore St
#4577
Saint Johns, MI 48879
Phone (989) 224-2313

1025 Ashmun St
#4579
Sault Sainte Marie, MI 49783
Phone (906) 632-6874

511 S Garfield Ave
Traverse City, MI 49686
Phone (231) 941-5332

511 S Garfield Ave
#4586
Traverse City, MI 49686
Phone (231) 941-5332

Practitioners & affiliated clinicians

Practitioners 31

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.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548028800000",
    "number": "1912196759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 371115",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152507115",
            "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": "200 NEWBERRY COMMONS",
            "city": "ETTERS",
            "state": "PA",
            "postal_code": "173199363",
            "telephone_number": "717-761-2633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PDS I MICHIGAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-17",
        "last_updated": "2019-01-21",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RITE AID CORPORATION",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "RITE AID CORPORATION",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Etters, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2019; 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.