Healthcare Provider Details

I. General information

NPI: 1003266693
Provider Name (Legal Business Name): RITE AID
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2016
Last Update Date: 06/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 N STATE ST
CONCORD NH
03301-5015
US

IV. Provider business mailing address

6 TUTTLE ST
CONCORD NH
03301-2442
US

V. Phone/Fax

Practice location:
  • Phone: 603-223-6713
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number4014
License Number StateNH

VIII. Authorized Official

Name: SHAUNA ARMIENTO
Title or Position: PDM
Credential:
Phone: 207-651-9167