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General NPI Number Information
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NPI Number | 1417335803
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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 | 05/18/2015
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Last Update Date | 05/18/2015
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Provider Practice Location Address
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Address Line | 163 W 26TH ST
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City | ERIE
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State | PA
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Zip | 16508-1803
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Country | US
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Telephone | 814-452-4012
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Fax |
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Provider Business Mailing Address
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Address Line | 1844 W GRANDVIEW BLVD APT 102
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City | ERIE
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State | PA
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Zip | 16509-1077
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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 | JAYE MENOHER
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Credential |
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Telephone | 814-323-9333
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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 | RP449137
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License Number State | PA
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