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General NPI Number Information
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NPI Number | 1558735761
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Entity Type | Organization
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Legal Business Name | RITE AID
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Dates
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Enumeration Date | 11/26/2015
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Last Update Date | 11/26/2015
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Provider Practice Location Address
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Address Line | 1998 BIDDLE AVE
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City | WYANDOTTE
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State | MI
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Zip | 48192-3907
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Country | US
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Telephone | 734-285-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 1998 BIDDLE AVE
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City | WYANDOTTE
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State | MI
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Zip | 48192-3907
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Country | US
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Telephone | 734-285-4100
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Fax |
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Authorized Official
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Title or Position | PHARMACY DISTRICT MANAGER
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Name | RUTH GRAHAM
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Credential |
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Telephone | 419-756-2819
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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 | 5302041092
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License Number State | MI
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