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General NPI Number Information
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NPI Number | 1740459197
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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 | 02/29/2008
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Last Update Date | 02/29/2008
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Provider Practice Location Address
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Address Line | 56 7TH AVE
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City | NEW YORK
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State | NY
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Zip | 10011-6672
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Country | US
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Telephone | 212-675-1697
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Fax |
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Provider Business Mailing Address
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Address Line | 56 7TH AVE
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City | NEW YORK
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State | NY
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Zip | 10011-6672
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Country | US
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Telephone | 212-675-1697
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Fax |
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Authorized Official
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Title or Position | SUPERVISING PHARMACIST
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Name | KATE C SO
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Credential | B.S.
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Telephone | 212-675-1697
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | 022581
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License Number State | NY
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