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General NPI Number Information
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NPI Number | 1245605773
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Entity Type | Organization
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Legal Business Name | RITE AID
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Dates
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Enumeration Date | 12/09/2015
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Last Update Date | 12/09/2015
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Provider Practice Location Address
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Address Line | 629 HIGHWAY 20 N
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City | HINES
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State | OR
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Zip | 97738-9435
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Country | US
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Telephone | 541-573-1523
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Fax | 541-573-1502
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Provider Business Mailing Address
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Address Line | 629 HIGHWAY 20 N
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City | HINES
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State | OR
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Zip | 97738-9435
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Country | US
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Telephone | 541-573-1523
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Fax | 541-573-1502
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Authorized Official
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Title or Position | PHARMACY DISTRICT MANAGER
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Name | RORY LAMBERT
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Credential | PHARMD
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Telephone | 208-343-4317
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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 | P7322
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0015069
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License Number State | OR
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