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General NPI Number Information
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NPI Number | 1215227178
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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 | 04/13/2011
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Last Update Date | 04/13/2011
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Provider Practice Location Address
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Address Line | 30 E OAK ST
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City | LEBANON
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State | OR
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Zip | 97355-3222
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Country | US
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Telephone | 541-451-8024
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Fax |
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Provider Business Mailing Address
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Address Line | 30 E OAK ST
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City | LEBANON
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State | OR
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Zip | 97355-3222
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Country | US
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Telephone | 541-451-8024
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | KIM ANDREWS
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Credential | PHARMD
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Telephone | 541-451-8024
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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 | 12329
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License Number State | OR
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