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General NPI Number Information
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NPI Number | 1073962940
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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 | 06/10/2016
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Last Update Date | 06/10/2016
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Provider Practice Location Address
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Address Line | 901 MERRICK RD
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City | COPIAGUE
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State | NY
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Zip | 11726-4903
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Country | US
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Telephone | 631-842-8096
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Fax |
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Provider Business Mailing Address
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Address Line | 901 MERRICK RD
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City | COPIAGUE
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State | NY
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Zip | 11726-4903
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | SARAH KIM
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Credential | RPH
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Telephone | 917-456-2926
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 055973
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License Number State | NY
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