Healthcare Provider Details

I. General information

NPI: 1396107900
Provider Name (Legal Business Name): RITE AID
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2016
Last Update Date: 03/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 BUTLER RD
KITTANNING PA
16201-2329
US

IV. Provider business mailing address

435 BEAR ST
WORTHINGTON PA
16262-2613
US

V. Phone/Fax

Practice location:
  • Phone: 724-543-2265
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberRP450047
License Number StatePA

VIII. Authorized Official

Name: ALYSSA DODD
Title or Position: PHARMACIST
Credential: PHARMD
Phone: 724-841-5997