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General NPI Number Information
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NPI Number | 1124314182
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Entity Type | Organization
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Legal Business Name | RITE AID CORPORATION
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Dates
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Enumeration Date | 06/28/2011
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Last Update Date | 06/28/2011
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Provider Practice Location Address
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Address Line | 1605 S SAN JACINTO AVE
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City | SAN JACINTO
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State | CA
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Zip | 92583-5181
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Country | US
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Telephone | 951-654-4734
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Fax |
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Provider Business Mailing Address
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Address Line | 4345 CLOUDYWING RD
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City | HEMET
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State | CA
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Zip | 92545-8948
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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 | MR. FAROOQ A PATEL
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Credential | RPH
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Telephone | 951-654-4734
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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 | RPH 45917
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License Number State | CA
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