MEDICARE: RITE AID

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	333600000X	Pharmacy	0202207673	VA

General Provider Information

NPI Number	:	1265751614
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RITE AID

Provider Business Mailing Address
First Line	:	1671 CRYSTAL SQUARE ARC
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22202-3322
Country	:	US
Telephone Number	:	703-413-0525
Fax Number	:	703-413-4451

Provider Business Practice Location Address
First Line	:	1671 CRYSTAL SQUARE ARC
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22202-3322
Country	:	US
Telephone Number	:	703-413-0525
Fax Number	:	703-413-4451

Authorized Official
Title or Position	:	IMMUNIZING PHARMACIST
Name	:	SARIKA JAHAGIRDAR
Credential	:	RPH
Telephone Number	:	703-413-0525

Provider Enumeration Date	:	05/25/2010
Last Update Date	:	05/25/2010

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Directions to “RITE AID ” Practice Location

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