Healthcare Provider Details

I. General information

NPI: 1508431081
Provider Name (Legal Business Name): RITE AID OF PENNSYLVANIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2021
Last Update Date: 05/26/2021
Certification Date: 05/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 E MARKET ST
CLEARFIELD PA
16830-2432
US

IV. Provider business mailing address

200 NEWBERRY CMNS
ETTERS PA
17319-9363
US

V. Phone/Fax

Practice location:
  • Phone: 814-765-7841
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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 M ZOREK
Title or Position: DIRECTOR
Credential:
Phone: 717-975-5937