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General NPI Number Information
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NPI Number | 1043628621
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Entity Type | Organization
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Legal Business Name | RITE AID PHARMACY
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Dates
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Enumeration Date | 07/28/2014
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Last Update Date | 07/28/2014
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Provider Practice Location Address
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Address Line | 1615 MONTGOMERY HWY
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City | HOOVER
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State | AL
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Zip | 35216-4901
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Country | US
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Telephone | 205-823-6091
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Fax |
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Provider Business Mailing Address
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Address Line | 100 CENTERVIEW DR SUITE 120
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City | VESTAVIA
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State | AL
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Zip | 35216-3747
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Country | US
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Telephone | 205-824-3652
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Fax |
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Authorized Official
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Title or Position | PHARMACY DISTRICT MANAGER
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Name | MR. JEFF CHURCH
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Credential | RPH
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Telephone | 205-824-3652
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 17808
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License Number State | AL
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