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General NPI Number Information
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NPI Number | 1528433174
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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 | 12/08/2015
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Last Update Date | 12/08/2015
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Provider Practice Location Address
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Address Line | 15 W CENTRE ST
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City | MAHANOY CITY
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State | PA
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Zip | 17948-2603
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Country | US
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Telephone | 570-590-8879
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Fax |
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Provider Business Mailing Address
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Address Line | 15 W CENTRE ST
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City | MAHANOY CITY
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State | PA
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Zip | 17948-2603
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Country | US
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Telephone | 570-590-8879
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Fax |
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Authorized Official
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Title or Position | DISTRICT MANAGER
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Name | MS. MANDY HOYSAN
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Credential | PHARM.D
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Telephone | 570-825-9481
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | RP025668L
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License Number State | PA
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