MEDICARE: RITEAID

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	RP042409L	PA

General Provider Information

NPI Number	:	1154734283
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RITEAID

Provider Business Mailing Address
First Line	:	9910 FRANKFORD AVE
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19114-1900
Country	:	US
Telephone Number	:	215-824-2700
Fax Number	:

Provider Business Practice Location Address
First Line	:	9910 FRANKFORD AVE
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19114-1900
Country	:	US
Telephone Number	:	215-824-2700
Fax Number	:

Authorized Official
Title or Position	:	PDM
Name	:	STACEY FOX
Credential	:
Telephone Number	:	215-677-0555

Provider Enumeration Date	:	06/05/2014
Last Update Date	:	06/05/2014

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Directions to “RITEAID ” Practice Location

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