Healthcare Provider Details

I. General information

NPI: 1285047167
Provider Name (Legal Business Name): RITE AID PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2014
Last Update Date: 06/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 W CHELTENHAM AVE
MELROSE PARK PA
19027-3131
US

IV. Provider business mailing address

1401 W CHELTENHAM AVE
MELROSE PARK PA
19027-3131
US

V. Phone/Fax

Practice location:
  • Phone: 215-782-8950
  • Fax: 215-782-8357
Mailing address:
  • Phone: 215-782-8950
  • Fax: 215-782-8357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberRP447045
License Number StatePA

VIII. Authorized Official

Name: DR. INDU RAJAPPAN NAIR
Title or Position: PHARMACY MANAGER
Credential: PHARMD
Phone: 215-782-8950