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General NPI Number Information
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NPI Number | 1508238742
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Entity Type | Organization
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Legal Business Name | RITE AID PHARMACY
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Dates
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Enumeration Date | 10/27/2015
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Last Update Date | 10/27/2015
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Provider Practice Location Address
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Address Line | 780 CHURCH ST NE
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City | MARIETTA
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State | GA
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Zip | 30060-7269
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Country | US
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Telephone | 770-427-5341
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Fax |
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Provider Business Mailing Address
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Address Line | 780 CHURCH STREET NE
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City | MARIETTA
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State | GA
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Zip | 30060
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Country | US
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Telephone | 770-427-5341
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | DR. ROMA PATEL
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Credential | PHARM.D
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Telephone | 770-427-5341
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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 | RPH028902
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License Number State | GA
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