MEDICARE: RITE AID OF PENNSYLVANIA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336C0003X	Community/Retail Pharmacy	PP415116L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	3970921	OTHER	OTHER ID NUMBER

General Provider Information

NPI Number	:	1255421285
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RITE AID OF PENNSYLVANIA LLC

Provider Business Mailing Address
First Line	:	200 NEWBERRY COMMONS
Second Line	:
City	:	ETTERS
State	:	PA
Zip	:	17319-9363
Country	:	US
Telephone Number	:	717-761-2633
Fax Number	:	717-975-8659

Provider Business Practice Location Address
First Line	:	1201 WEST GIRARD AVENUE
Second Line	:	43
City	:	PHILADELPHIA
State	:	PA
Zip	:	19123-1003
Country	:	US
Telephone Number	:	215-236-4859
Fax Number	:

Authorized Official
Title or Position	:	MANAGER ONLINE ADJUDICATION
Name	:	JENNIFER ZOREK
Credential	:
Telephone Number	:	717-975-5937

Provider Enumeration Date	:	10/13/2006
Last Update Date	:	04/06/2020

Similar Medicare Providers

1417334905 — DR. DUC DO PHARMD
Practice Location Address:

1201 W GIRARD AVE
PHILADELPHIA, PA
19123-1003

Practice Phone: 215-236-4859
Practice Fax:

1336529940 — JOANN FRANCIS
Practice Location Address:

2204 SOUTH ST FRNT 1003
PHILADELPHIA, PA
19146-2078

Practice Phone: 302-729-3695
Practice Fax:

1821084583 — DR. JOSEPH FRANK MUSSOLINE M.D.
Practice Location Address:

1637 S BROAD ST
PHILADELPHIA, PA
19148-1003

Practice Phone: 215-465-7100
Practice Fax: 215-463-3550

1093703233 — DR. ANTHONY THANH LAM D.M.D.
Practice Location Address:

1611 S BROAD ST
PHILADELPHIA, PA
19148-1003

Practice Phone: 215-271-6999
Practice Fax:

1578551628 — ANTHONY T. LAM, DMD, PC
Practice Location Address:

1611 S BROAD ST
PHILADELPHIA, PA
19148-1003

Practice Phone: 215-271-6999
Practice Fax:

1932190113 — THOMAS HUNG LAM DMD
Practice Location Address:

1611 S BROAD ST
PHILADELPHIA, PA
19148-1003

Practice Phone: 215-271-6999
Practice Fax:

Directions to “RITE AID OF PENNSYLVANIA LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.