Healthcare Provider Details

I. General information

NPI: 1487067351
Provider Name (Legal Business Name): RITE AID PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2014
Last Update Date: 06/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7941 OXFORD AVE
PHILADELPHIA PA
19111-2224
US

IV. Provider business mailing address

7941 OXFORD AVE
PHILADELPHIA PA
19111-2224
US

V. Phone/Fax

Practice location:
  • Phone: 215-745-9060
  • Fax: 215-745-0481
Mailing address:
  • Phone: 215-745-9060
  • Fax: 215-745-0481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberRP040442L
License Number StatePA

VIII. Authorized Official

Name: MRS. SUSAN MATHEW
Title or Position: PHARMACIST
Credential:
Phone: 215-745-9060