Healthcare Provider Details

I. General information

NPI: 1235539412
Provider Name (Legal Business Name): RITE AID
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2014
Last Update Date: 08/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2158 BROWNSVILLE RD
PITTSBURGH PA
15210-4206
US

IV. Provider business mailing address

2158 BROWNSVILLE RD
PITTSBURGH PA
15210-4206
US

V. Phone/Fax

Practice location:
  • Phone: 412-881-6439
  • Fax:
Mailing address:
  • Phone: 412-881-6439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP447538
License Number StatePA

VIII. Authorized Official

Name: ELLEN RAE DIXON
Title or Position: PHARMACIST
Credential: PHARMD
Phone: 724-448-8923