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General NPI Number Information
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NPI Number | 1437566825
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Entity Type | Organization
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Legal Business Name | RITEAID PHARMACY
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Dates
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Enumeration Date | 07/17/2014
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Last Update Date | 07/17/2014
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Provider Practice Location Address
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Address Line | 423 BOSTON POST RD
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City | SUDBURY
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State | MA
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Zip | 01776
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Country | US
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Telephone | 978-443-0410
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Fax |
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Provider Business Mailing Address
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Address Line | 423 BOSTON POST RD
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City | SUDBURY
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State | MA
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Zip | 01776
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Country | US
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Telephone | 978-443-0410
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Fax |
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Authorized Official
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Title or Position | STAFF PHARMACIST
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Name | MRS. TRACY NGUYEN
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Credential | PHARM. D
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Telephone | 774-239-9153
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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 | 45977
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License Number State | TX
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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 | PH27289
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License Number State | MA
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