Healthcare Provider Details

I. General information

NPI: 1568919116
Provider Name (Legal Business Name): RITE AID
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2016
Last Update Date: 09/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 SOUTH STREET
BLUE HILL ME
04614-0335
US

IV. Provider business mailing address

PO BOX 335 17 SOUTH STREET
BLUE HILL ME
04614-0335
US

V. Phone/Fax

Practice location:
  • Phone: 207-374-3565
  • Fax: 207-374-3523
Mailing address:
  • Phone: 207-374-3565
  • Fax: 207-374-3523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER ZOREK
Title or Position: MANAGER ONLINE ADJUDICATION
Credential:
Phone: 717-975-5937