Healthcare Provider Details

I. General information

NPI: 1467869453
Provider Name (Legal Business Name): RITE AID CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2014
Last Update Date: 07/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 N STATE ST
OREM UT
84057-2548
US

IV. Provider business mailing address

622 E GARFIELD AVE
SALT LAKE CITY UT
84105-3023
US

V. Phone/Fax

Practice location:
  • Phone: 801-762-0396
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number70368141701
License Number StateUT

VIII. Authorized Official

Name: HEATHER HIERLING
Title or Position: CLINICAL ADMINISTRATOR
Credential:
Phone: 916-852-1883