Healthcare Provider Details

I. General information

NPI: 1174937759
Provider Name (Legal Business Name): RITE AID
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2014
Last Update Date: 06/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6515 CASTOR AVE
PHILADELPHIA PA
19149-2708
US

IV. Provider business mailing address

6515 CASTOR AVE
PHILADELPHIA PA
19149-2708
US

V. Phone/Fax

Practice location:
  • Phone: 215-535-2800
  • Fax: 215-288-6557
Mailing address:
  • Phone: 215-535-2800
  • Fax: 215-288-6557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP448231
License Number StatePA

VIII. Authorized Official

Name: MR. HAO TRAN
Title or Position: PHARMACIST DISTRICT MANAGER
Credential: PHARMD
Phone: 215-464-3171