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General NPI Number Information
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NPI Number | 1326404302
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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 | 01/06/2016
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Last Update Date | 01/06/2016
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Provider Practice Location Address
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Address Line | 7301 THEODORE DAWES RD
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City | THEODORE
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State | AL
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Zip | 36582-4029
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Country | US
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Telephone | 251-653-9831
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Fax |
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Provider Business Mailing Address
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Address Line | 8917 N DAVIS HWY APT 70
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City | PENSACOLA
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State | FL
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Zip | 32514-5328
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | ABBEY JUNGCLAUS
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Credential |
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Telephone | 812-569-0832
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 19033
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License Number State | AL
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