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General NPI Number Information
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NPI Number | 1467821728
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Entity Type | Organization
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Legal Business Name | RITE AID PHARMCY
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Dates
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Enumeration Date | 09/17/2015
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Last Update Date | 09/17/2015
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Provider Practice Location Address
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Address Line | 5811 TELEGRAPH RD
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City | TAYLOR
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State | MI
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Zip | 48180-1214
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Country | US
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Telephone | 313-291-2697
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Fax |
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Provider Business Mailing Address
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Address Line | 7019 YINGER AVE
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City | DEARBORN
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State | MI
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Zip | 48126-1732
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Country | US
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Telephone | 313-918-9813
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | RIDHWAN AHMED ALBANEH
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Credential | PHARMD
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Telephone | 313-918-9813
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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 | 5302040875
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License Number State | MI
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