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General NPI Number Information
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NPI Number | 1275948945
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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 | 06/21/2014
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Last Update Date | 06/21/2014
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Provider Practice Location Address
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Address Line | 3687 HIGHWAY 5
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City | DOUGLASVILLE
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State | GA
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Zip | 30135-2385
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Country | US
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Telephone | 770-577-8979
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Fax |
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Provider Business Mailing Address
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Address Line | 950 W PEACHTREE ST NW UNIT 1001
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City | ATLANTA
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State | GA
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Zip | 30309-3846
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Country | US
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Telephone | 615-238-7279
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | JESSICA RAVEN NORTHCUTT
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Credential | PHARMD
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Telephone | 615-238-7279
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 027466
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License Number State | GA
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