Healthcare Provider Details

I. General information

NPI: 1740644962
Provider Name (Legal Business Name): RITE AID
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2016
Last Update Date: 04/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 HUDSON AVE
GUILFORD ME
04443-6300
US

IV. Provider business mailing address

3 HUDSON AVE
GUILFORD ME
04443-6300
US

V. Phone/Fax

Practice location:
  • Phone: 207-876-2788
  • Fax: 207-876-2621
Mailing address:
  • Phone: 207-876-2788
  • Fax: 207-876-2621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPR45368
License Number StateME

VIII. Authorized Official

Name: JUN YE
Title or Position: STAFF PHARMACIST
Credential: RPH
Phone: 207-404-0111