Provider Demographics
NPI:1124431416
Name:RITEAID PHARMACY
Entity type:Organization
Organization Name:RITEAID PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:OPOKU-GYEBI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD, MPA
Authorized Official - Phone:717-975-0117
Mailing Address - Street 1:4957 CARLISLE PIKE
Mailing Address - Street 2:PHARMACY
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-3025
Mailing Address - Country:US
Mailing Address - Phone:717-975-0117
Mailing Address - Fax:
Practice Address - Street 1:4957 CARLISLE PIKE
Practice Address - Street 2:PHARMACY
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-3025
Practice Address - Country:US
Practice Address - Phone:717-975-0117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-04
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP4470593336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy