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General NPI Number Information
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NPI Number | 1932653573
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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 | 08/11/2016
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Last Update Date | 08/11/2016
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Provider Practice Location Address
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Address Line | 2 N PARK ST
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City | CAMBRIDGE
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State | NY
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Zip | 12816-1105
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Country | US
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Telephone | 518-677-3822
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Fax |
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Provider Business Mailing Address
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Address Line | 3D FULHAM RD
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City | CLIFTON PARK
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State | NY
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Zip | 12065-6323
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Country | US
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Telephone | 518-368-9801
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | JASON KUBIK
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Credential | PHARMD
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Telephone | 518-368-9801
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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 | 20 058240
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License Number State | NY
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