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General NPI Number Information
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NPI Number | 1184005175
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Entity Type | Organization
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Legal Business Name | RITE AID CORP.
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Dates
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Enumeration Date | 06/15/2015
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Last Update Date | 06/15/2015
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Provider Practice Location Address
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Address Line | 639 ALPHA DR
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City | PITTSBURGH
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State | PA
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Zip | 15238-2819
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Country | US
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Telephone | 412-967-8733
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Fax |
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Provider Business Mailing Address
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Address Line | 1314 HILLSDALE AVE
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City | PITTSBURGH
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State | PA
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Zip | 15216-2502
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Country | US
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Telephone | 412-977-8299
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | THOMAS OTROBA
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Credential | PHARM.D.
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Telephone | 412-977-8299
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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 | RP449238
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License Number State | PA
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