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General NPI Number Information
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NPI Number | 1457726705
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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 | 12/10/2015
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Last Update Date | 12/10/2015
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Provider Practice Location Address
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Address Line | 1633 DULANEY DR
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City | JARRETTSVILLE
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State | MD
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Zip | 21084-1514
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Country | US
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Telephone | 410-692-7736
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Fax |
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Provider Business Mailing Address
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Address Line | 1633 DULANEY DR
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City | JARRETTSVILLE
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State | MD
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Zip | 21084-1514
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Country | US
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Telephone | 410-692-7736
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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. EDWARD THOMAS CASTLE
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Credential | BS
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Telephone | 410-467-7004
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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 | 10025
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License Number State | MD
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