Provider Demographics
NPI:1124319264
Name:RITE AID
Entity type:Organization
Organization Name:RITE AID
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:MAURINO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:530-310-1717
Mailing Address - Street 1:1450 PAIUTE LN
Mailing Address - Street 2:
Mailing Address - City:SUSANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:96130-3585
Mailing Address - Country:US
Mailing Address - Phone:530-310-1717
Mailing Address - Fax:
Practice Address - Street 1:2960 MAIN ST
Practice Address - Street 2:
Practice Address - City:SUSANVILLE
Practice Address - State:CA
Practice Address - Zip Code:96130-4730
Practice Address - Country:US
Practice Address - Phone:530-257-0603
Practice Address - Fax:530-257-2737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-24
Last Update Date:2011-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35354282N00000X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
No282N00000XHospitalsGeneral Acute Care HospitalGroup - Multi-Specialty