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General NPI Number Information
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NPI Number | 1568812105
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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 | 06/14/2016
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Last Update Date | 06/14/2016
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Provider Practice Location Address
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Address Line | 177 OLD MILL RD APT 5
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City | EPHRATA
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State | PA
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Zip | 17522-1990
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Country | US
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Telephone | 717-666-5610
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Fax |
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Provider Business Mailing Address
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Address Line | 177 OLD MILL RD APT 5
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City | EPHRATA
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State | PA
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Zip | 17522-1990
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Country | US
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Telephone | 717-666-5610
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | PETER S MINA
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Credential |
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Telephone | 717-666-5610
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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 | PH100002282
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License Number State | DC
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