MEDICARE: RITE AID OF VIRGINIA INC

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	291U00000X	Clinical Medical Laboratory
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	3336C0003X	Community/Retail Pharmacy	0201002588	VA

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	4822789	OTHER	OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1518076819
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RITE AID OF VIRGINIA INC

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	:	1533 EAST PEMBROKE AVENUE
Second Line	:
City	:	HAMPTON
State	:	VA
Zip	:	23663-2038
Country	:	US
Telephone Number	:	757-728-9649
Fax Number	:

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	04/04/2023

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Directions to “RITE AID OF VIRGINIA INC ” Practice Location

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