Rite Aid of New York Inc

Organization Active NPI Community/Retail Pharmacy · Greenville, NY

NPI 1972612356 · NPPES record last updated Oct 6, 2011

Key facts

NPI
1972612356
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
024347 (NY)
Legal business name
RITE AID OF NEW YORK INC
Practice address
5 Garland Lane
Greenville, NY 12083-3410
Phone
(518) 966-8612
NPI assigned
Aug 30, 2006
Organization subpart
No

Authorized official

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100820000438 NY Part B Supplier - Mass Immunization (Roster Biller Only) 6800920273 This NPI is an additional NPI on the enrollment

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X 024347 NY Yes

Addresses

Primary practice location

5 Garland Lane
Greenville, NY 12083-3410

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
3302217OtherOTHER ID NUMBER
01904856MedicaidNY

Other names

  • RITE AID PHARMACY 02686 Doing business as

Other providers in Greenville, NY

All providers in Greenville, NY · Community/Retail Pharmacy in New York

Sources for this page

Verify at the official NPI Registry.