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General NPI Number Information
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NPI Number | 1275822744
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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 | 04/05/2011
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Last Update Date | 04/05/2011
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Provider Practice Location Address
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Address Line | 2141 S CRATER RD
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City | PETERSBURG
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State | VA
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Zip | 23805-2701
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Country | US
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Telephone | 804-733-3471
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Fax | 804-733-3984
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Provider Business Mailing Address
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Address Line | 2141 S CRATER RD
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City | PETERSBURG
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State | VA
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Zip | 23805-2701
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Country | US
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Telephone | 804-733-3471
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Fax | 804-733-3984
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | MRS. FELICIA SHERRY BRACEY
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Credential | R.PH
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Telephone | 804-733-3471
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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 | 0202011049
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License Number State | VA
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