Rite Aid of Michigan Inc
Organization Active NPI Community/Retail Pharmacy · Bridgeport, MI
NPI 1942319488 · NPPES record last updated Apr 17, 2009
Key facts
- NPI
- 1942319488
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 4063 (MI)
- Legal business name
- RITE AID OF MICHIGAN INC
- Practice address
- 6155 Dixie Highway
Bridgeport, MI 48722-9618 - Phone
- (989) 777-3550
- NPI assigned
- Aug 29, 2006
- Organization subpart
- No
Authorized official
- Name
- Jennifer Zorek
- Title
- Manager Online Adjudication
- Phone
- (717) 975-5937
Practitioners 8
-
Adwoa Frimpomaa Atakora, PHARMD
-
Catherine Chun Dato, PHARM.D.
-
Suzanne Lorraine Gibbs, CPHT
-
David Michael Purkis, RPH
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050902000356 | MI | Part B Supplier - Mass Immunization (Roster Biller Only) | 0840222501 | This NPI is an additional NPI on the enrollment |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Community/Retail Pharmacy | 3336C0003X | 4063 | MI | Yes |
Addresses
Primary practice location
6155 Dixie Highway
Bridgeport, MI 48722-9618
Mailing address
200 Newberry Commons
Etters, PA 17319-9363
Phone (717) 761-2633
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2337245 | Medicaid | MI | |
| 2337245 | Other | OTHER ID NUMBER COMMERCIAL NUMBER |
Other names
- RITE AID PHARMACY 01551
Other providers in Bridgeport, MI
- Mona Reeves
- Renue 004 Bridgeport, LLC
- Joo Young Rhee
- Adrienne Richards
- Nia Riley
- Jaida Robinson
- Tina Marie Rodarte
- Lyndee Rodriguez
- Tansley Love Rogers
- Saginaw Valley Sport & Spine LP
All providers in Bridgeport, MI · Community/Retail Pharmacy in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 17, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.