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	PP414539L	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	3963558	OTHER	OTHER ID NUMBER

General Provider Information

NPI Number	:	1629167374
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	:	5201 SPRING ROAD
Second Line	:	SUITE 6
City	:	SHERMANS DALE
State	:	PA
Zip	:	17090-8582
Country	:	US
Telephone Number	:	717-582-7781
Fax Number	:

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

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	08/17/2020

Similar Medicare Providers

1447625637 — PARTH UPENDRA TEJANI
Practice Location Address:

5201 SPRING RD STE 6
SHERMANS DALE, PA
17090-8582

Practice Phone: 717-582-7781
Practice Fax:

1063986735 — SHAHUL ABUSALIH
Practice Location Address:

5201 SPRING RD STE 6
SHERMANS DALE, PA
17090-8582

Practice Phone: 717-582-7781
Practice Fax:

1902883093 — DR. GERALD JOSEPH KRUBA D.C.
Practice Location Address:

5761 SPRING RD
SHERMANS DALE, PA
17090-8613

Practice Phone: 717-582-7900
Practice Fax: 717-582-3027

1891730503 — BETTY TOMS BSC, PHARM.D
Practice Location Address:

5201 SPRING RD
SHERMANS DALE, PA
17090-8539

Practice Phone: 717-582-7781
Practice Fax: 717-582-4657

1134139082 — DR. RICHARD GROVER BISBING M.D.
Practice Location Address:

4570 VALLEY RD
SHERMANS DALE, PA
17090-0276

Practice Phone: 717-582-2090
Practice Fax: 717-582-7090

1669482527 — DR. STEVEN ROY CREPS M.D.
Practice Location Address:

4570 VALLEY RD
SHERMANS DALE, PA
17090

Practice Phone: 717-582-2090
Practice Fax: 717-582-7090

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.