Healthcare Provider Details

I. General information

NPI: 1891194080
Provider Name (Legal Business Name): RITE AID PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2014
Last Update Date: 08/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8130 ROOSEVELT BLVD
PHILADELPHIA PA
19152-2911
US

IV. Provider business mailing address

8130 ROOSEVELT BLVD
PHILADELPHIA PA
19152-2911
US

V. Phone/Fax

Practice location:
  • Phone: 215-331-0160
  • Fax:
Mailing address:
  • Phone: 215-331-0160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberRP448894
License Number StatePA

VIII. Authorized Official

Name: MR. NABIL H DHARSI
Title or Position: PHARMACIST
Credential: PHARMD
Phone: 717-514-6026