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General NPI Number Information
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NPI Number | 1811317654
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Entity Type | Organization
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Legal Business Name | RITE AID CORPORATION
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Dates
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Enumeration Date | 04/20/2014
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Last Update Date | 04/20/2014
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Provider Practice Location Address
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Address Line | 761 PIERREMONT RD
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City | SHREVEPORT
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State | LA
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Zip | 71106-2211
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Country | US
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Telephone | 318-861-3666
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Fax |
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Provider Business Mailing Address
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Address Line | 761 PIERREMONT RD
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City | SHREVEPORT
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State | LA
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Zip | 71106-2211
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Country | US
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Telephone | 318-861-3666
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | ZEENA R PATEL
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Credential |
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Telephone | 318-341-1074
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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 | 020513
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License Number State | LA
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