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General NPI Number Information
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NPI Number | 1063872067
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Entity Type | Organization
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Legal Business Name | RITE AID
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Dates
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Enumeration Date | 03/03/2016
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Last Update Date | 03/03/2016
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Provider Practice Location Address
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Address Line | 59 N PLANK RD
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City | NEWBURGH
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State | NY
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Zip | 12550-2126
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Country | US
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Telephone | 845-565-2786
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 256
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City | MONTGOMERY
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State | NY
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Zip | 12549-0256
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Country | US
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Telephone | 423-461-6081
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Fax |
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Authorized Official
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Title or Position | RITE AID DISTRICT MANAGER
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Name | SANDEEP CHAKRABARTI
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Credential | PHARMD
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Telephone | 845-565-2786
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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 | PCT.0013563
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 061433
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License Number State | NY
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