Healthcare Provider Details

I. General information

NPI: 1801242920
Provider Name (Legal Business Name): RITE AID
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2016
Last Update Date: 05/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 REED ST
PHILADELPHIA PA
19146-3520
US

IV. Provider business mailing address

3000 REED ST
PHILADELPHIA PA
19146-3520
US

V. Phone/Fax

Practice location:
  • Phone: 215-467-7920
  • Fax:
Mailing address:
  • Phone: 215-467-7920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP449883
License Number StatePA

VIII. Authorized Official

Name: MISS JESSE MCCULLOUGH
Title or Position: CLINICAL ADMINISTRATOR
Credential:
Phone: 412-967-8508