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General NPI Number Information
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NPI Number | 1861627895
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Entity Type | Organization
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Legal Business Name | RITEAID
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Dates
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Enumeration Date | 05/19/2009
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Last Update Date | 05/19/2009
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Provider Practice Location Address
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Address Line | 265 PASCACK RD
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City | TOWNSHIP OF WASHINGTON
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State | NJ
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Zip | 07676-4809
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Country | US
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Telephone | 201-665-5289
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Fax | 201-664-5298
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Provider Business Mailing Address
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Address Line | 265 PASCACK RD
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City | TOWNSHIP OF WASHINGTON
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State | NJ
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Zip | 07676-4809
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Country | US
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Telephone | 201-665-5289
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Fax | 201-664-5298
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Authorized Official
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Title or Position | CLINICAL MANAGER
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Name | MISS AMANDA GLOVER
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Credential | RPH
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Telephone | 717-975-8676
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 28RI02375600
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License Number State | NJ
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