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General NPI Number Information
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NPI Number | 1225583107
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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 | 08/19/2016
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Last Update Date | 08/19/2016
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Provider Practice Location Address
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Address Line | 7796 MUNSON RD
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City | MENTOR
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State | OH
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Zip | 44060-3745
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Country | US
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Telephone | 440-257-6258
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Fax |
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Provider Business Mailing Address
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Address Line | 647 ROBIN DR
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City | EASTLAKE
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State | OH
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Zip | 44095-1613
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Country | US
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Telephone | 440-289-3836
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Fax |
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Authorized Official
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Title or Position | PHARMACY DISTRICT MANAGER
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Name | SHELLY BOYLE
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Credential |
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Telephone | 234-284-5838
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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 | 03135868-1
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License Number State | OH
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