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General NPI Number Information
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NPI Number | 1760780233
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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 | 03/08/2011
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Last Update Date | 03/08/2011
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Provider Practice Location Address
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Address Line | 1526 6TH AV. SE
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City | DECATUR
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State | AL
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Zip | 35601-4561
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Country | US
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Telephone | 256-353-1196
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Fax |
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Provider Business Mailing Address
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Address Line | 1526 6TH AV. SE
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City | DECATUR
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State | AL
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Zip | 35601-4561
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | MR. BACHU PATEL
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Credential | BACHELOR OF PHARMACY
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Telephone | 256-353-1196
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 9345
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License Number State | AL
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