Healthcare Provider Details

I. General information

NPI: 1396295705
Provider Name (Legal Business Name): RITE AID PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2016
Last Update Date: 10/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 ROCK RIDGE RD
WESTERLY RI
02891-3704
US

IV. Provider business mailing address

31 ROCK RIDGE RD
WESTERLY RI
02891-3704
US

V. Phone/Fax

Practice location:
  • Phone: 401-322-1247
  • Fax:
Mailing address:
  • Phone: 401-322-1247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPCI.0007626
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHL04635
License Number StateRI

VIII. Authorized Official

Name: ALEXANDRA ERASMIA HAYES
Title or Position: STUDENT PHARMACIST
Credential:
Phone: 401-207-4601