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General NPI Number Information
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NPI Number | 1083027114
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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 | 06/06/2014
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Last Update Date | 06/06/2014
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Provider Practice Location Address
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Address Line | 260 W LEHIGH AVE PHARMACY DEPT
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City | PHILADELPHIA
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State | PA
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Zip | 19133-3425
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Country | US
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Telephone | 215-425-3784
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Fax | 215-425-0740
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Provider Business Mailing Address
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Address Line | 260 W LEHIGH AVE PHARMACY DEPT
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City | PHILADELPHIA
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State | PA
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Zip | 19133-3425
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Country | US
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Telephone | 215-425-3784
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Fax | 215-425-0740
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Authorized Official
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Title or Position | PHARMACIST
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Name | DR. VU NGUYEN
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Credential | PHARM.D
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Telephone | 267-516-3155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | RP443662
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License Number State | PA
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