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General NPI Number Information
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NPI Number | 1376837245
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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 | 06/08/2011
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Last Update Date | 06/08/2011
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Provider Practice Location Address
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Address Line | 25 ROBERTS CT
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City | KINGSTON
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State | RI
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Zip | 02881-1792
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Country | US
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Telephone | 401-353-4076
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Fax |
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Provider Business Mailing Address
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Address Line | 25 ROBERTS CT
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City | KINGSTON
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State | RI
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Zip | 02881-1792
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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 | MR. ROBERT E BRESLIN
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Credential |
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Telephone | 401-742-2098
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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 | MA22282
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License Number State | MA
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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 | 04494
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License Number State | RI
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